Evaluation of a novel system for hypothermic oxygenated pulsatile perfusion preservation.
BACKGROUND
Recently, a novel innovative machine perfusion (MP) system for hypothermic oxygenated pulsatile perfusion called the Airdrive (AD) has been developed. The aim of the study was to evaluate the biological safety of the AD system for perfusion preservation of kidney grafts in a porcine autotransplantation model using the low-viscosity perfusion solution Polysol (PS) in comparison with cold storage (CS) using PS or the University of Wisconsin solution (UW). In addition, we evaluated real-time microcirculation parameters. At sacrifice, grafts were retrieved for histological analysis and immunohistochemistry.


METHODS
After assessment of the microcirculation, left kidneys were retrieved. Following the washout, kidneys were preserved for 20 hr using AD-PS, CS-PS or CS-UW. Thereafter, contralateral kidneys were removed followed by heterotopic autotransplantation of the preserved graft. Seven days after transplantation animals were sacrificed with retrieval of the grafts for histological analysis. Renal function, renal microcirculation and tissue injury including the proliferative response of tubular epithelial cells (TECs) were compared.


RESULTS
Preservation using AD-PS or CS-PS resulted in higher microcirculatory flow compared with CS-UW. Improved recovery of renal function was seen in the AD-PS and CS-PS groups compared with CS-UW. Structural integrity was better preserved using AD-PS compared with both CS groups. Proliferative response of TECs was higher in CS-UW preserved grafts compared to grafts preserved using AD-PS.


CONCLUSIONS
This study demonstrates the biological safety of the AD system in a porcine autotransplantation model. Also, the microcirculation was better preserved and less morphological injury was observed after 20 hr MP compared with CS.
Doorschodt
Benedict M
BM
Institute for Laboratory Animal Science and Experimental Surgery, RWTH-Aachen University, Aachen, Germany.
Schreinemachers
Marie-Claire J M
MC
Florquin
Sandrine
S
Lai
Wei
W
Sitzia
Mario
M
Zernecke
Alma
A
Tolba
Rene H
RH
D000241:Adenosine / Q000494:pharmacology; D000493:Allopurinol / Q000494:pharmacology; D000818:Animals; D049109:Cell Proliferation; D050377:Cold Ischemia / Q000009:adverse effects / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D005978:Glutathione / Q000494:pharmacology; D007150:Immunohistochemistry; D007328:Insulin / Q000494:pharmacology; D007668:Kidney / Q000098:blood supply / Q000187:drug effects / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017078:Laser-Doppler Flowmetry; D008833:Microcirculation; D023421:Models, Animal; D019188:Organ Preservation Solutions / Q000494:pharmacology; D010100:Oxygen / Q000378:metabolism*; D010477:Perfusion / Q000009:adverse effects / Q000295:instrumentation; D011673:Pulsatile Flow; D011887:Raffinose / Q000494:pharmacology; D020127:Recovery of Function; D012079:Renal Circulation; D013552:Swine; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000295:instrumentation; D014182:Transplantation, Autologous
D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; C504758:polysol solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose; D010100:Oxygen