title: Role of oxygenation in hypothermic machine perfusion of kidneys from heart beating donors.
abstract: Dynamic preservation of organ grafts by hypothermic machine perfusion (HMP) has regained broader interest to provide better outcome after transplantation. One pivotal aspect still under debate is the role of oxygenation during HMP. The present study investigates functional and molecular aspects of active oxygenation during HMP of kidneys from heart beating donors.
  
  
  METHODS
  Kidneys were retrieved from Landrace pigs (25-30 kg body weight) and preserved by pulsatile HMP for 21 hr. All kidneys were randomly assigned to either anoxic perfusion (MPanox) or active oxygenation of the perfusate (MPox). All grafts were then autotransplanted, and the remaining native kidney was removed at the same time. Renal integrity and function was evaluated during perfusion and for 1 week after the transplantation and the removal of the remaining native kidney.
  
  
  RESULTS
  Oxygenation during HMP resulted in lower endischemic vascular resistance and slightly elevated free radical-mediatedtissue injury during HMP. After reperfusion, radical mediated lipid peroxidation was twofold higher in the MPanox group. Renal clearance of creatinine was found significantly better during the first 2 days after transplantation after MPanox than after MPox. Molecular expression of erythropoietin was increased threefold to baseline levels after MPanox, indicating renal hypoxia during preservation, but was remained unchanged after MPox. Gene expression of sodium-glucose transporter reflected similar functional outcome in both groups. Fractional excretion of Na(+), proteinuria, or serum levels of lactate dehydrogenase were similar in both groups.
  
  
  CONCLUSIONS
  The present data do not support the use of active oxygenation during hypothermic perfusion of kidneys from donors with intact circulation.
authors.affiliation: Surgical Research Division, University Clinic of Surgery, Bonn, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Gallinat
authors.forename: Andreas
authors.initials: A
authors.lastname: Paul
authors.forename: Patrik
authors.initials: P
authors.lastname: Efferz
authors.forename: Bastian
authors.initials: B
authors.lastname: Lüer
authors.forename: Sandra
authors.initials: S
authors.lastname: Swoboda
authors.forename: Dieter
authors.initials: D
authors.lastname: Hoyer
authors.forename: Thomas
authors.initials: T
authors.lastname: Minor
mesh_terms: D000818:Animals; D003404:Creatinine / Q000097:blood; D004921:Erythropoietin / Q000096:biosynthesis; D007036:Hypothermia, Induced / Q000295:instrumentation*; D007668:Kidney / Q000098:blood supply*; D016030:Kidney Transplantation; D015227:Lipid Peroxidation; D009926:Organ Preservation; D010100:Oxygen / Q000494:pharmacology*; D010477:Perfusion / Q000295:instrumentation*; D013481:Superoxides / Q000378:metabolism; D013552:Swine; D014019:Tissue Donors
chemical_list: D013481:Superoxides; D004921:Erythropoietin; D003404:Creatinine; D010100:Oxygen