title: Beneficial Effect of Short Pretransplant Period of Hypothermic Pulsatile Perfusion of the Warm-Ischemic Kidney after Cold Storage: Experimental Study.
abstract: Warm ischemia (WI) produces a significant deleterious effect in potential kidney grafts. Hypothermic machine perfusion (HMP) seems to improve immediate graft function after transplant. Our aim was to analyze the effect of short pretransplant periods of pulsatile HMP on histology and renal injury in warm-ischemic kidneys. Twelve minipigs were used. WI was achieved in the right kidney by applying a vascular clamp for 45 min. After nephrectomy, autotransplant was performed following one of two strategies: cold storage of the kidneys or cold storage combined with perfusion in pulsatile HMP. The graft was removed early to study renal morphology, inflammation (fibrosis), and apoptosis. Proinflammatory activity and fibrosis were less pronounced after cold storage of the kidneys with HMP than after cold storage only. The use of HMP also decreased apoptosis compared with cold storage only. The detrimental effects on cells of an initial and prolonged period of WI seem to improve with a preservation protocol that includes a short period of pulsatile HMP after cold storage and immediately before the transplant, in comparison with cold storage only.
authors.affiliation: Renal Physiopathology Laboratory, Department of Nephrology, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain.
authors.forename: Alberto
authors.identifier: 0000-0002-1095-679X
authors.initials: A
authors.lastname: Lázaro
authors.affiliation: Renal Physiopathology Laboratory, Department of Nephrology, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Humanes
authors.affiliation: Renal Physiopathology Laboratory, Department of Nephrology, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Jado
authors.affiliation: Renal Physiopathology Laboratory, Department of Nephrology, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain.
authors.forename: Marina
authors.initials: M
authors.lastname: Mojena
authors.affiliation: Renal Physiopathology Laboratory, Department of Nephrology, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain.
authors.forename: María Ángeles
authors.initials: MÁ
authors.lastname: González-Nicolás
authors.affiliation: Medicine and Surgery Unit, IiSGM, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; Department of Surgery, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain.
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Del Cañizo
authors.affiliation: Renal Physiopathology Laboratory, Department of Nephrology, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; Department of Medicine, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain.
authors.forename: Alberto
authors.identifier: 0000-0003-0596-9227
authors.initials: A
authors.lastname: Tejedor
authors.affiliation: Urology Department, IiSGM, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Lledó-García
mesh_terms: D000818:Animals; D003080:Cold Temperature; D007668:Kidney / Q000473:pathology / Q000502:physiology / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods / Q000706:statistics & numerical data; D010477:Perfusion / Q000379:methods*; D013552:Swine; D013556:Swine, Miniature; D013997:Time Factors; D014022:Tissue Survival; D019737:Transplants / Q000502:physiology / Q000706:statistics & numerical data