title: Gradual Rewarming with Gradual Increase in Pressure during Machine Perfusion after Cold Static Preservation Reduces Kidney Ischemia Reperfusion Injury.
abstract: In this study we evaluated whether gradual rewarming after the period of cold ischemia would improve organ quality in an Isolated Perfused Kidney Model. Left rat kidneys were statically cold stored in University of Wisconsin solution for 24 hours at 4°C. After cold storage kidneys were rewarmed in one of three ways: perfusion at body temperature (38°C), or rewarmed gradually from 10°C to 38°C with stabilization at 10°C for 30 min and rewarmed gradually from 10°C to 38°C with stabilization at 25°C for 30 min. In the gradual rewarming groups the pressure was increased stepwise to 40 mmHg at 10°C and 70 mmHg at 25°C to counteract for vasodilatation leading to low perfusate flows. Renal function parameters and injury biomarkers were measured in perfusate and urine samples. Increases in injury biomarkers such as aspartate transaminase and lactate dehydrogenase in the perfusate were lower in the gradual rewarming groups versus the control group. Sodium re-absorption was improved in the gradual rewarming groups and reached significance in the 25°C group after ninety minutes of perfusion. HSP-70, ICAM-1, VCAM-1 mRNA expressions were decreased in the 10°C and 25°C groups. Based on the data kidneys that underwent gradual rewarming suffered less renal parenchymal, tubular injury and showed better endothelial preservation. Renal function improved in the gradual rewarming groups versus the control group.
authors.affiliation: Dept of Surgery, Groningen Transplant Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.|Dept. of Surgery, Division of Transplantation, University of Massachusetts, Worcester, MA, United States of America.
authors.forename: Paria
authors.initials: P
authors.lastname: Mahboub
authors.affiliation: Dept of Surgery, Groningen Transplant Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Petra
authors.initials: P
authors.lastname: Ottens
authors.affiliation: Dept of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Marc
authors.initials: M
authors.lastname: Seelen
authors.forename: Nils
authors.initials: N
authors.lastname: 't Hart
authors.affiliation: Dept of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Nails
authors.initials: N
authors.lastname: t Hart
authors.affiliation: Dept of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Harry
authors.initials: H
authors.lastname: Van Goor
authors.forename: Rutger
authors.initials: R
authors.lastname: Ploeg
authors.affiliation: Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
authors.forename: Paulo N
authors.initials: PN
authors.lastname: Martins
authors.affiliation: Dept. of Surgery, Division of Transplantation, University of Massachusetts, Worcester, MA, United States of America.
authors.forename: Paulo
authors.initials: P
authors.lastname: Martins
authors.affiliation: Dept of Surgery, Groningen Transplant Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Henri
authors.initials: H
authors.lastname: Leuvenink
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D001831:Body Temperature; D003080:Cold Temperature; D015925:Cryopreservation / Q000379:methods*; D004734:Energy Metabolism; D006439:Hemodynamics; D007668:Kidney / Q000098:blood supply / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D016030:Kidney Transplantation; D015227:Lipid Peroxidation; D008297:Male; D010477:Perfusion / Q000379:methods*; D011312:Pressure; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D051381:Rats; D015427:Reperfusion Injury / Q000235:genetics / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control*; D017694:Rewarming / Q000379:methods*; D013997:Time Factors
chemical_list: D015415:Biomarkers; D012333:RNA, Messenger; D000255:Adenosine Triphosphate