title: A Study of Normothermic Hemoperfusion of the Porcine Pancreas and Kidney.
abstract: Normothermic machine perfusion has enormous potential to improve organ preservation and expand the organ donor pool. It is well established in other organs but not the pancreas, which has especially strict organ acceptance criteria. We established a model of normothermic hemoperfusion of the porcine pancreas with and without addition of the kidney as a dialysis organ. Four pancreases were harvested and perfused for 120 min with autologous whole blood at body temperature, two with parallel perfusion of the kidney and two without. The organs and perfusion circuit were evaluated for gross appearance, pH, histology and perfusion parameters. The organs maintained steadily increasing flow rate and perfusion pressure. Gross appearance of the organs was stable but appeared grossly ischemic toward the end of the perfusion period. Histology demonstrated necrosis centered in acinar tissue but islet cells were preserved. pH was significantly alkalotic toward the end of the perfusion, likely due to pancreatic tissue damage. Addition of the kidney did not result in significant improvement of the acid-base environment in this small series. In conclusion, normothermic perfusion of the pancreas is still in the experimental stages but holds great potential. Further studies to optimize perfusion parameters will significantly improve results. Parallel perfusion of the kidney may facilitate improvement in the acid-base environment.
authors.affiliation: Department of Surgery, The Queen Elizabeth Hospital, University of Adelaide, Woodville, SA, Australia.
authors.forename: Kean Guan
authors.initials: KG
authors.lastname: Kuan
authors.affiliation: Department of Surgery, The Queen Elizabeth Hospital, University of Adelaide, Woodville, SA, Australia.
authors.forename: Mau Nam
authors.initials: MN
authors.lastname: Wee
authors.affiliation: Department of Hepatobiliary Surgery, Leicester General Hospital, Leicester, UK.
authors.forename: Wen Yuan
authors.initials: WY
authors.lastname: Chung
authors.affiliation: Department of Hepatobiliary Surgery, Leicester General Hospital, Leicester, UK.
authors.forename: Rohan
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Surgery, The Queen Elizabeth Hospital, University of Adelaide, Woodville, SA, Australia.
authors.forename: Soeren Torge
authors.initials: ST
authors.lastname: Mees
authors.affiliation: Department of Hepatobiliary Surgery, Leicester General Hospital, Leicester, UK.
authors.forename: Ashley
authors.initials: A
authors.lastname: Dennison
authors.affiliation: Department of Surgery, The Queen Elizabeth Hospital, University of Adelaide, Woodville, SA, Australia.
authors.forename: Guy
authors.initials: G
authors.lastname: Maddern
authors.affiliation: Department of Surgery, The Queen Elizabeth Hospital, University of Adelaide, Woodville, SA, Australia.
authors.forename: Markus
authors.initials: M
authors.lastname: Trochsler
mesh_terms: D000818:Animals; D001775:Blood Circulation; D001831:Body Temperature; D006863:Hydrogen-Ion Concentration; D007511:Ischemia / Q000209:etiology / Q000473:pathology; D007668:Kidney / Q000098:blood supply* / Q000737:chemistry / Q000473:pathology / Q000648:ultrastructure*; D009336:Necrosis / Q000209:etiology / Q000473:pathology; D009926:Organ Preservation / Q000009:adverse effects / Q000379:methods*; D010179:Pancreas / Q000098:blood supply* / Q000737:chemistry / Q000473:pathology / Q000648:ultrastructure*; D010477:Perfusion / Q000009:adverse effects / Q000379:methods*; D013552:Swine; D013696:Temperature
keywords: -Extracorporeal perfusion; -Kidney; -Pancreas; -Transplant; Normothermic perfusion