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Journal articles on the topic 'Normothermic Machine Perfusion'

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Author: Grafiati

Published: 14 March 2023

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1

Hann, A., H. Lembach, A. Nutu, B. Dassanayake, S. Tillakaratne, S. C. McKay, A. P. C. S. Boteon, et al. "Outcomes of normothermic machine perfusion of liver grafts in repeat liver transplantation (NAPLES initiative)." British Journal of Surgery 109, no. 4 (February 15, 2022): 372–80. http://dx.doi.org/10.1093/bjs/znab475.

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Abstract Background Retransplantation candidates are disadvantaged owing to lack of good-quality liver grafts. Strategies that can facilitate transplantation of suboptimal grafts into retransplant candidates require investigation. The aim was to determine whether late liver retransplantation can be performed safely with suboptimal grafts, following normothermic machine perfusion. Methods A prospectively enrolled group of patients who required liver retransplantation received a suboptimal graft preserved via normothermic machine perfusion. This group was compared with both historical and contemporaneous cohorts of patient who received grafts preserved by cold storage. The primary outcome was 6-month graft and patient survival. Results The normothermic machine perfusion group comprised 26 patients. The historical (cold storage 1) and contemporaneous (cold storage 2) groups comprised 31 and 25 patients respectively. The 6-month graft survival rate did not differ between groups (cold storage 1, 27 of 31, cold storage 2, 22 of 25; normothermic machine perfusion, 22 of 26; P = 0.934). This was despite the normothermic machine perfusion group having significantly more steatotic grafts (8 of 31, 7 of 25, and 14 of 26 respectively; P = 0.006) and grafts previously declined by at least one other transplant centre (5 of 31, 9 of 25, and 21 of 26; P < 0.001). Conclusion In liver retransplantation, normothermic machine perfusion can safely expand graft options without compromising short-term outcomes.

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2

Liew, Belle, David Nasralla, Satheesh Iype, Joerg-Matthias Pollok, Brian Davidson, and Dimitri A. Raptis. "Liver transplant outcomes after ex vivo machine perfusion: a meta-analysis." British Journal of Surgery 108, no. 12 (November 17, 2021): 1409–16. http://dx.doi.org/10.1093/bjs/znab364.

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Abstract Background The pressure on liver-transplant programmes has expanded the usage of extended-criteria allografts. Machine perfusion may be better than conventional static cold storage (SCS) in alleviating ischaemia–reperfusion injury in this setting. Recipient outcomes with hypothermic or normothermic machine perfusion were assessed against SCS here. Methods A search in MEDLINE, EMBASE and Scopus was conducted in February 2021. Primary studies investigating ex vivo machine perfusion were assessed for the following outcomes: morbidity, ICU and hospital stay, graft and patient survival rates and relative costs. Meta-analysis was performed to obtain pooled summary measures. Results Thirty-four articles involving 1742 patients were included, of which 20 were used for quantitative synthesis. Odds ratios favoured hypothermic machine perfusion (over SCS) with less early allograft dysfunction, ischaemic cholangiopathy, non-anastomotic strictures and graft loss. Hypothermic machine perfusion was associated with a shorter hospital stay and normothermic machine perfusion with reduced graft injury. Two randomized clinical trials found normothermic machine perfusion reduced major complication risks. Conclusion Machine perfusion assists some outcomes with potential cost savings.

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Goumard, Claire, Célia Turco, Mehdi Sakka, Lynda Aoudjehane, Philippe Lesnik, Eric Savier, Filomena Conti, and Olivier Scatton. "Ex-Vivo Pharmacological Defatting of the Liver: A Review." Journal of Clinical Medicine 10, no. 6 (March 18, 2021): 1253. http://dx.doi.org/10.3390/jcm10061253.

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The ongoing organ shortage has forced transplant teams to develop alternate sources of liver grafts. In this setting, ex-situ machine perfusion has rapidly developed as a promising tool to assess viability and improve the function of organs from extended criteria donors, including fatty liver grafts. In particular, normothermic machine perfusion represents a powerful tool to test a liver in full 37 °C metabolism and add pharmacological corrections whenever needed. In this context, many pharmacological agents and therapeutics have been tested to induce liver defatting on normothermic machine perfusion with promising results even on human organs. This systematic review makes a comprehensive synthesis on existing pharmacological therapies for liver defatting, with special focus on normothermic liver machine perfusion as an experimental ex-vivo translational model.

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Weissenbacher, Annemarie, and James Hunter. "Normothermic machine perfusion of the kidney." Current Opinion in Organ Transplantation 22, no. 6 (December 2017): 571–76. http://dx.doi.org/10.1097/mot.0000000000000470.

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5

Mergental, Hynek, and Garrett R. Roll. "Normothermic machine perfusion of the liver." Clinical Liver Disease 10, no. 4 (October 2017): 97–99. http://dx.doi.org/10.1002/cld.661.

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6

Croome, Kristopher P. "Introducing Machine Perfusion into Routine Clinical Practice for Liver Transplantation in the United States: The Moment Has Finally Come." Journal of Clinical Medicine 12, no. 3 (January 23, 2023): 909. http://dx.doi.org/10.3390/jcm12030909.

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While adoption of machine perfusion technologies into clinical practice in the United States has been much slower than in Europe, recent changes in the transplant landscape as well as device availability following FDA approval have paved the way for rapid growth. Machine perfusion may provide one mechanism to maximize the utilization of potential donor liver grafts. Indeed, multiple studies have shown increased organ utilization with the implementation of technologies such as ex-situ normothermic machine perfusion (NMP), ex-situ hypothermic machine perfusion (HMP) and in-situ normothermic regional perfusion (NRP). The current review describes the history and development of machine perfusion utilization in the Unites States along with future directions. It also describes the differences in landscape between Europe and the United States and how this has shaped clinical application of these technologies.

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Prudhomme, Thomas, Delphine Kervella, Stéphanie Le Bas-Bernardet, Diego Cantarovich, Georges Karam, Gilles Blancho, and Julien Branchereau. "Ex situ Perfusion of Pancreas for Whole-Organ Transplantation: Is it Safe and Feasible? A Systematic Review." Journal of Diabetes Science and Technology 14, no. 1 (August 13, 2019): 120–34. http://dx.doi.org/10.1177/1932296819869312.

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Introduction: Pancreas transplantation is currently one of the best treatments proposed in highly selected patients with unstable and brittle type 1 diabetes. The objective of pancreas transplantation is to restore normoglycemia and avoid the occurrence of complications associated with diabetes. Graft pancreatitis and thrombosis, arising from ischemia reperfusion injuries, are major causes of graft loss in the postoperative period. Ex situ perfusion, in hypothermic or normothermic settings, allowed to improve ischemic reperfusion injury in other organ transplantations (kidney, liver, or lung). The development of pancreatic graft perfusion techniques would limit these ischemic reperfusion injuries. Objective: Evaluation of the safety and feasibility of ex situ perfusion of pancreas for whole-organ transplantation. Methods: English literature about pancreas perfusion was analyzed using electronic database Medline via PubMed (1950-2018). Exclusion criteria were studies that did not specify the technical aspects of machine perfusion and studies focused only on pancreas perfusion for islet isolation. Results: Hypothermic machine perfusion for pancreas preservation has been evaluated in nine studies and normothermic machine perfusion in ten studies. We evaluated machine perfusion model, types of experimental model, anatomy, perfusion parameters, flushing and perfusion solution, length of perfusion, and comparison between static cold storage and perfusion. Conclusions: This review compared ex vivo machine perfusion of experimental pancreas for whole-organ transplantation. Pancreas perfusion is feasible and could be a helpful tool to evaluate pancreas prior to transplantation. Pancreas perfusion (in hypothermic or normothermic settings) could reduce ischemic reperfusion injuries, and maybe could avoid pancreas thrombosis and reduce morbidity of pancreas transplantation.

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8

op den Dries, S., N. Karimian, and R. J. Porte. "Normothermic Machine Perfusion of Discarded Liver Grafts." American Journal of Transplantation 13, no. 9 (September 2013): 2504. http://dx.doi.org/10.1111/ajt.12374.

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9

Karimian, Negin, Siavash Raigani, Viola Huang, Sonal Nagpal, Ehab O. A. Hafiz, Irene Beijert, Paria Mahboub, et al. "Subnormothermic Machine Perfusion of Steatotic Livers Results in Increased Energy Charge at the Cost of Anti-Oxidant Capacity Compared to Normothermic Perfusion." Metabolites 9, no. 11 (October 24, 2019): 246. http://dx.doi.org/10.3390/metabo9110246.

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There continues to be significant debate regarding the most effective mode of ex situ machine perfusion of livers for transplantation. Subnormothermic (SNMP) and normothermic machine perfusion (NMP) are two methods with different benefits. We examined the metabolomic profiles of discarded steatotic human livers during three hours of subnormothermic or normothermic machine perfusion. Steatotic livers regenerate higher stores of ATP during SNMP than NMP. However, there is a significant depletion of available glutathione during SNMP, likely due to an inability to overcome the high energy threshold needed to synthesize glutathione. This highlights the increased oxidative stress apparent in steatotic livers. Rescue of discarded steatotic livers with machine perfusion may require the optimization of redox status through repletion or supplementation of reducing agents.

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10

Large, Stephen, and Simon Messer. "Machine Perfusion of the Human Heart." Transplantology 3, no. 1 (March 18, 2022): 109–14. http://dx.doi.org/10.3390/transplantology3010011.

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This brief communication about machine perfusion of potential human donor hearts describes its historical development. Included in the review are both the isolated perfusion of donor hearts retrieved from heart beating and non-heart-beating donors. Additionally, some detail of in-situ (within the donor body) normothermic regional reperfusion of the heart and other organs is given. This only applies to the DCD donor heart. Similarly, some detail of ex-situ (outside the body) heart perfusion is offered. This article covers the entire history of the reperfusion of donor hearts. It takes us up to the current day describing 6 years follow-up of these donor machine perfused hearts. These clinical results appear similar to the outcomes of heart beating donors if reperfusion is managed within 30 min of normothermic circulatory determined death. Future developments are also offered. These are 3-fold and include: i. the pressing need for objective markers of the clinical outcome after transplantation, ii. the wish for isolated heart perfusion leading to improvement in donor heart quality, and iii. a strategy to safely lengthen the duration of isolated heart perfusion.

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11

Nostedt, Jordan J., Daniel T. Skubleny, A. M. James Shapiro, Sandra Campbell, Darren H. Freed, and David L. Bigam. "Normothermic Ex Vivo Machine Perfusion for Liver Grafts Recovered from Donors after Circulatory Death: A Systematic Review and Meta-Analysis." HPB Surgery 2018 (April 23, 2018): 1–8. http://dx.doi.org/10.1155/2018/6867986.

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As a result of donation after circulatory death liver grafts’ poor tolerance to cold storage, there has been increasing research interest in normothermic machine perfusion. This study aims to systematically review the current literature comparing normothermic perfusion to cold storage in donation after circulatory death liver grafts and complete a meta-analysis of published large animal and human studies. A total of nine porcine studies comparing cold storage to normothermic machine perfusion for donation after circulatory death grafts were included for analysis. There was a significant reduction in AST (mean difference −2291 U/L, CI (−3019, −1563); P ≤ 0.00001) and ALT (mean difference −175 U/L, CI (−266, −85); P=0.0001), for normothermic perfusion relative to static cold storage, with moderate (I2 = 61%) and high (I2 = 96%) heterogeneity, respectively. Total bile production was also significantly higher (mean difference = 174 ml, CI (155, 193); P≤0.00001). Further research focusing on standardization, performance of this technology following periods of cold storage, economic implications, and clinical trial data focused on donation after circulatory death grafts will be helpful to advance this technology toward routine clinical utilization for these grafts.

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12

Bagnenko, S. F., O. N. Reznik, A. E. Skvortsov, A. V. Lopota, N. A. Gryaznov, V. V. Kharlamov, and G. S. Kireeva. "Experimental perfusion device for preservation of donor’s liver." Grekov's Bulletin of Surgery 176, no. 3 (June 28, 2017): 88–92. http://dx.doi.org/10.24884/0042-4625-2017-176-3-88-92.

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OBJECTIVE. The authors aimed to develop complex perfusion medical device in order to successfully maintain viability of donor liver until transplantation. MATERIAL AND METHODS. Experimental perfusion device for normothermic perfusion donor’s liver was developed and tested in the Central Research and Experimental-design Institute of Robotics and Technical Cybernetics. RESULTS. The pre-clinical tests were performed on porcine liver. It was demonstrated that normothermic machine perfusion could restore liver function after 30 minutes of warm ischemia time and provide normalization of biochemical parameters of organ functioning.

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13

Melandro, Fabio, Riccardo De Carlis, Francesco Torri, Andrea Lauterio, Paolo De Simone, Luciano De Carlis, and Davide Ghinolfi. "Viability Criteria during Liver Ex-Situ Normothermic and Hypothermic Perfusion." Medicina 58, no. 10 (October 11, 2022): 1434. http://dx.doi.org/10.3390/medicina58101434.

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With the increased use of extended-criteria donors, machine perfusion became a beneficial alternative to cold storage in preservation strategy for donor livers with the intent to expand donor pool. Both normothermic and hypothermic approach achieved good results in terms of mid- and long-term outcome in liver transplantation. Many markers and molecules have been proposed for the assessment of liver, but no definitive criteria for graft viability have been validated in large clinical trials and key parameters during perfusion still require optimization.In this review, we address the current literature of viability criteria during normothermic and hypothermic machine perfusion and discuss about future steps and evolution of these technologies.

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14

Gilmour, Jenny, Chelsea Griffiths, Tom Pither, William E. Scott, and Andrew J. Fisher. "Normothermic machine perfusion of donor-lungs ex-vivo." Current Opinion in Organ Transplantation 25, no. 3 (June 2020): 285–92. http://dx.doi.org/10.1097/mot.0000000000000765.

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15

Hameed, Ahmer M., David B. Lu, Ellis Patrick, Bo Xu, Min Hu, Yi Vee Chew, Karen Keung, et al. "Brief Normothermic Machine Perfusion Rejuvenates Discarded Human Kidneys." Transplantation Direct 5, no. 11 (November 2019): e502. http://dx.doi.org/10.1097/txd.0000000000000944.

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16

Ionescu, Mihnea-Ioan, Suchintha Tillakaratne, James Hodson, Bridget Gunson, David Nasralla, Amanda Pinter Carvalheiro da Silva Boteon, Kate Sermon, et al. "Normothermic Machine Perfusion Enhances Intraoperative Hepatocellular Synthetic Capacity." Transplantation 103, no. 7 (July 2019): e198-e207. http://dx.doi.org/10.1097/tp.0000000000002720.

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17

Schlegel, Andrea, and Philipp Dutkowski. "Impact of Machine Perfusion on Biliary Complications after Liver Transplantation." International Journal of Molecular Sciences 19, no. 11 (November 12, 2018): 3567. http://dx.doi.org/10.3390/ijms19113567.

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We describe in this review the different types of injuries caused to the biliary tree after liver transplantation. Furthermore, we explain underlying mechanisms and why oxygenated perfusion concepts could not only protect livers, but also repair high-risk grafts to prevent severe biliary complications and graft loss. Accordingly, we summarize experimental studies and clinical applications of machine liver perfusion with a focus on biliary complications after liver transplantation. Key points: (1) Acute inflammation with subsequent chronic ongoing liver inflammation and injury are the main triggers for cholangiocyte injury and biliary tree transformation, including non-anastomotic strictures; (2) Hypothermic oxygenated perfusion (HOPE) protects livers from initial oxidative injury at normothermic reperfusion after liver transplantation. This is a unique feature of a cold oxygenation approach, which is effective also end-ischemically, e.g., after cold storage, due to mitochondrial repair mechanisms. In contrast, normothermic oxygenated perfusion concepts protect by reducing cold ischemia, and are therefore most beneficial when applied instead of cold storage; (3) Due to less downstream activation of cholangiocytes, hypothermic oxygenated perfusion also significantly reduces the development of biliary strictures after liver transplantation.

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18

Smith, Thomas B., Michael L. Nicholson, and Sarah A. Hosgood. "Advances in Hypothermic and Normothermic Perfusion in Kidney Transplantation." Transplantology 2, no. 4 (November 17, 2021): 460–77. http://dx.doi.org/10.3390/transplantology2040044.

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Hypothermic and normothermic machine perfusion in kidney transplantation are purported to exert a beneficial effect on post-transplant outcomes compared to the traditionally used method of static cold storage. Kidney perfusion techniques provide a window for organ reconditioning and quality assessment. However, how best to deliver these preservation methods or improve organ quality has not yet been conclusively defined. This review summarises the promising advances in machine perfusion science in recent years, which have the potential to further improve early graft function and prolong graft survival.

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19

Lascaris, Bianca, Adam M. Thorne, Ton Lisman, Maarten W. N. Nijsten, Robert J. Porte, and Vincent E. de Meijer. "Long-term normothermic machine preservation of human livers: what is needed to succeed?" American Journal of Physiology-Gastrointestinal and Liver Physiology 322, no. 2 (February 1, 2022): G183—G200. http://dx.doi.org/10.1152/ajpgi.00257.2021.

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Although short‐term machine perfusion (≤24 h) allows for resuscitation and viability assessment of high‐risk donor livers, the donor organ shortage might be further remedied by long‐term perfusion machines. Extended preservation of injured donor livers may allow reconditioning, repairing, and regeneration. This review summarizes the necessary requirements and challenges for long‐term liver machine preservation, which requires integrating multiple core physiological functions to mimic the physiological environment inside the body. A pump simulates the heart in the perfusion system, including automatically controlled adjustment of flow and pressure settings. Oxygenation and ventilation are required to account for the absence of the lungs combined with continuous blood gas analysis. To avoid pressure necrosis and achieve heterogenic tissue perfusion during preservation, diaphragm movement should be simulated. An artificial kidney is required to remove waste products and control the perfusion solution’s composition. The perfusate requires an oxygen carrier, but will also be challenged by coagulation and activation of the immune system. The role of the pancreas can be mimicked through closed‐loop control of glucose concentrations by automatic injection of insulin or glucagon. Nutrients and bile salts, generally transported from the intestine to the liver, have to be supplemented when preserving livers long term. Especially for long‐term perfusion, the container should allow maintenance of sterility. In summary, the main challenge to develop a long‐term perfusion machine is to maintain the liver’s homeostasis in a sterile, carefully controlled environment. Long‐term machine preservation of human livers may allow organ regeneration and repair, thereby ultimately solving the shortage of donor livers.

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20

Lignell, Stina, Stine Lohmann, Kaithlyn M. Rozenberg, Henri G. D. Leuvenink, Merel B. F. Pool, Kate R. Lewis, Cyril Moers, et al. "Improved Normothermic Machine Perfusion After Short Oxygenated Hypothermic Machine Perfusion of Ischemically Injured Porcine Kidneys." Transplantation Direct 7, no. 2 (January 15, 2021): e653. http://dx.doi.org/10.1097/txd.0000000000001108.

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21

Pezzati, D., Q. Liu, A. Hassan, T. Diago-Uso, L. Buccini, and C. Quintini. "Normothermic Machine Perfusion: A New World Deserving Careful Exploration." American Journal of Transplantation 17, no. 7 (March 22, 2017): 1956–57. http://dx.doi.org/10.1111/ajt.14249.

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22

Martins, Paulo N., Julianna E. Buchwald, Hynek Mergental, Luciano Vargas, and Cristiano Quintini. "The role of normothermic machine perfusion in liver transplantation." International Journal of Surgery 82 (October 2020): 52–60. http://dx.doi.org/10.1016/j.ijsu.2020.05.026.

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23

Ceresa, Carlo D. L., David Nasralla, Constantin C. Coussios, and Peter J. Friend. "The case for normothermic machine perfusion in liver transplantation." Liver Transplantation 24, no. 2 (January 29, 2018): 269–75. http://dx.doi.org/10.1002/lt.25000.

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24

Reiling, Janske, David S. R. Lockwood, Andrew H. Simpson, Catherine M. Campbell, Kim R. Bridle, Nishreen Santrampurwala, Laurence J. Britton, Darrell H. G. Crawford, Cornelius H. C. Dejong, and Jonathan Fawcett. "Urea production during normothermic machine perfusion: Price of success?" Liver Transplantation 21, no. 5 (April 1, 2015): 700–703. http://dx.doi.org/10.1002/lt.24094.

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25

Georgiades, Fanourios, Sarah A. Hosgood, Andrew J. Butler, and Michael L. Nicholson. "Use of ex vivo normothermic machine perfusion after normothermic regional perfusion to salvage a poorly perfused DCD kidney." American Journal of Transplantation 19, no. 12 (August 23, 2019): 3415–19. http://dx.doi.org/10.1111/ajt.15547.

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26

Pavel, Mihai-Calin, Ernest Reyner, Josep Fuster, and Juan Carlos Garcia-Valdecasas. "Liver Transplantation From Type II Donation After Cardiac Death Donor With Normothermic Regional Perfusion and Normothermic Machine Perfusion." Cirugía Española (English Edition) 96, no. 8 (October 2018): 508–13. http://dx.doi.org/10.1016/j.cireng.2018.09.010.

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27

Mohkam, K., D. Nasralla, H. Mergental, X. Muller, T. Perera, R. Laing, J. Y. Mabrut, et al. "Normothermic Regional Perfusion or Normothermic Machine Perfusion in Liver Transplantation from Donation after Circulatory Death: A First Comparative Study." HPB 23 (2021): S669. http://dx.doi.org/10.1016/j.hpb.2021.08.002.

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Chadha, Radhika, Mohammad Ayaz Hossain, and Atul Bagul. "Optimising organs for transplantation: is normothermic machine perfusion the answer?" Expert Review of Medical Devices 13, no. 3 (February 20, 2016): 221–23. http://dx.doi.org/10.1586/17434440.2016.1146587.

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29

Gilbo, Nicholas, Tine Wylin, Veerle Heedfeld, Ina Jochmans, Jacques Pirenne, Peter Friend, and Diethard Monbaliu. "Porcine Liver Normothermic Machine Perfusion: Methodological Framework and Potential Pitfalls." Transplantation Direct 8, no. 1 (December 13, 2021): e1276. http://dx.doi.org/10.1097/txd.0000000000001276.

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30

Arykbaeva, Asel S., Dorottya K. de Vries, Jason B. Doppenberg, Marten A. Engelse, Thomas Hankemeier, Amy C. Harms, Leonie G. Wijermars, et al. "Metabolic needs of the kidney graft undergoing normothermic machine perfusion." Kidney International 100, no. 2 (August 2021): 301–10. http://dx.doi.org/10.1016/j.kint.2021.04.001.

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Thompson, Emily R., Avinash Sewpaul, Rodrigo Figuereido, Lucy Bates, Samuel J. Tingle, John R. Ferdinand, Gerhard R. Situmorang, et al. "MicroRNA antagonist therapy during normothermic machine perfusion of donor kidneys." American Journal of Transplantation 22, no. 4 (January 4, 2022): 1088–100. http://dx.doi.org/10.1111/ajt.16929.

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Knaak, J. M., V. N. Spetzler, N. Selzner, and M. Selzner. "Normothermic Machine Perfusion of Discarded Liver Grafts-What Is Viable?" American Journal of Transplantation 13, no. 9 (September 2013): 2503. http://dx.doi.org/10.1111/ajt.12377.

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Hosgood, Sarah A., Ernest van Heurn, and Michael L. Nicholson. "Normothermic machine perfusion of the kidney: better conditioning and repair?" Transplant International 28, no. 6 (May 8, 2014): 657–64. http://dx.doi.org/10.1111/tri.12319.

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Nassar, Ahmed, and Cristiano Quintini. "Vasodilation During Normothermic Machine Perfusion; Preventing the No-Reflow Phenomena." Transplantation 102, no. 4 (April 2018): 548–49. http://dx.doi.org/10.1097/tp.0000000000002072.

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35

Chen, Guodong, Xiaoshun He, Changxi Wang, Xiaopeng Yuan, Ming Han, and Zhiyong Guo. "ACCOMPLISHMENT OF ISCHEMIA-FREE KIDNEY TRANSPLANTATION USING NORMOTHERMIC MACHINE PERFUSION." Transplantation 104, S3 (September 2020): S256. http://dx.doi.org/10.1097/01.tp.0000699764.86835.c1.

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36

Adams, Thomas D., Sarah A. Hosgood, and Michael L. Nicholson. "Physiological effects of altering oxygenation during kidney normothermic machine perfusion." American Journal of Physiology-Renal Physiology 316, no. 5 (May 1, 2019): F823—F829. http://dx.doi.org/10.1152/ajprenal.00178.2018.

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Kidney normothermic machine perfusion (NMP) has historically used a 95% O2-5% CO2 gas mixture. Using a porcine model of organ retrieval, NMP, and reperfusion, we tested the hypothesis that reducing perfusate oxygenation ([Formula: see text]) would be detrimental to renal function and cause injury. In the minimal ischemic injury experiment, kidneys sustained 10 min of warm ischemia and 2 h of static cold storage before 1 h of NMP with either 95%, 25%, or 12% O2 with 5% CO2 and N2 balance. In the clinical injury experiment, kidneys with 10-min warm ischemia and 17-h static cold storage underwent 1-h NMP with the above gas combinations or 18-h static cold storage as a control. They were then reperfused with whole blood and 95% O2 for 3 h. Overall, reducing [Formula: see text] did not significantly influence renal function in either experiment. Furthermore, there were no differences in the injury markers urinary neutrophil gelatinase-associated lipocalin or tissue high-motility group box protein 1. In the minimal ischemic injury experiment, a [Formula: see text] of 25% significantly reduced renal blood flow and increased vascular resistance. Oxygen delivery, consumption, and extraction (oxygen extraction ratio) were significantly greater at 95% [Formula: see text]. In the clinical injury experiment, renal blood flow was significantly increased at 25% [Formula: see text] and Na+ excretion decreased. At 95% [Formula: see text], the oxygen content and oxygen extraction ratio were significantly increased. During reperfusion, renal blood flow was significantly increased in the 25% group. The control group pH was significantly decreased compared with the 25% group. Our data suggest that reducing [Formula: see text] during NMP does not have detrimental effects on renal function or markers of injury.

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37

Nassar, Ahmed, Qiang Liu, Kevin Farias, Giuseppe D’Amico, Cynthia Tom, Patrick Grady, Ana Bennett, et al. "Ex Vivo Normothermic Machine Perfusion Is Safe, Simple, and Reliable." Surgical Innovation 22, no. 1 (April 2, 2014): 61–69. http://dx.doi.org/10.1177/1553350614528383.

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38

Meszaros, Andras T., Julia Hofmann, Madita L. Buch, Benno Cardini, Theresia Dunzendorfer-Matt, Florian Nardin, Michael J. Blumer, et al. "Mitochondrial respiration during normothermic liver machine perfusion predicts clinical outcome." eBioMedicine 85 (November 2022): 104311. http://dx.doi.org/10.1016/j.ebiom.2022.104311.

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Mathur, A., K. Fung, A. Del Portillo, A. Griesemer, T. Kato, and J. Emond. "Sequential Normothermic Regional Perfusion and Normothermic Machine Perfusion May Improve Hepatic Artery Resistance and Accelerate Lactate Normalization in DCD Livers." HPB 24 (2022): S560—S561. http://dx.doi.org/10.1016/j.hpb.2022.05.1217.

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40

Morsy, Mohamed, Mohammad Ayaz Hossain, and Atul Bagul. "Exploring the Role of Mesenchymal Stem Cells During Normothermic Organ Perfusion: A New Paradigm to Enhance Outcome Following Allograft Transplantation." Open Stem Cell Journal 5, no. 1 (November 30, 2018): 47–52. http://dx.doi.org/10.2174/1876893801805010047.

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Background: Normothermic Machine Perfusion (NMP) has been established in the field of solid organ transplantation for both liver and kidney allografts. The ability to perfuse organs at body temperature enables viability assessment as well as optimisation prior to implantation. Discussion: A recent in vitro report of the use of Mesenchymal Stem Cells (MSCs) in the use of a normothermic lung perfusion circuit has raised the possibility of their use in solid organ transplantation. The aim of this short review is to outline the potential uses of bone marrow derived MSCs for their use in renal allograft ex vivo NMP. An overview is provided of current literature of NMP as well as theorised uses for MSCs.

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Mathis, Simon, Gabriel Putzer, Stefan Schneeberger, and Judith Martini. "The Endothelial Glycocalyx and Organ Preservation—From Physiology to Possible Clinical Implications for Solid Organ Transplantation." International Journal of Molecular Sciences 22, no. 8 (April 13, 2021): 4019. http://dx.doi.org/10.3390/ijms22084019.

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The endothelial glycocalyx is a thin layer consisting of proteoglycans, glycoproteins and glycosaminoglycans that lines the luminal side of vascular endothelial cells. It acts as a barrier and contributes to the maintenance of vascular homeostasis and microperfusion. During solid organ transplantation, the endothelial glycocalyx of the graft is damaged as part of Ischemia Reperfusion Injury (IRI), which is associated with impaired organ function. Although several substances are known to mitigate glycocalyx damage, it has not been possible to use these substances during graft storage on ice. Normothermic machine perfusion (NMP) emerges as an alternative technology for organ preservation and allows for organ evaluation, but also offers the possibility to treat and thus improve organ quality during storage. This review highlights the current knowledge on glycocalyx injury during organ transplantation, presents ways to protect the endothelial glycocalyx and discusses potential glycocalyx protection strategies during normothermic machine perfusion.

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Hameed, Ahmer, Suat Dervish, Natasha Rogers, Henry Pleass, and Wayne Hawthorne. "A novel, customized 3D-printed perfusion chamber for normothermic machine perfusion of the kidney." Transplant International 32, no. 1 (October 28, 2018): 107–9. http://dx.doi.org/10.1111/tri.13361.

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Yoshida, Kozue, Shunsuke Nakamura, Hiroki Sakamoto, Mika Kondo, Takehiro Chouno, Yasuhiro Ikegami, Nana Shirakigawa, et al. "Normothermic machine perfusion system satisfying oxygen demand of liver could maintain liver function more than subnormothermic machine perfusion." Journal of Bioscience and Bioengineering 131, no. 1 (January 2021): 107–13. http://dx.doi.org/10.1016/j.jbiosc.2020.08.011.

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Nassar, Ahmed, Qiang Liu, Kevin Farias, Giuseppe D'Amico, Laura Buccini, Daniel Urcuyo, Dympna Kelly, et al. "Role of Vasodilation during Normothermic Machine Perfusion of DCD Porcine Livers." International Journal of Artificial Organs 37, no. 2 (February 2014): 165–72. http://dx.doi.org/10.5301/ijao.5000297.

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Li, Jiahao, Haoyang Lu, Jian Zhang, Yixuan Li, and Qiang Zhao. "Comprehensive Approach to Assessment of Liver Viability During Normothermic Machine Perfusion." Journal of Clinical and Translational Hepatology 000, no. 000 (September 13, 2022): 000. http://dx.doi.org/10.14218/jcth.2022.00130.

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Shapiro, A. M. J. "Response to “Normothermic Machine Perfusion: A New World Deserving Careful Exploration”." American Journal of Transplantation 17, no. 7 (April 11, 2017): 1958. http://dx.doi.org/10.1111/ajt.14281.

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Woud, Wouter W., Ana Merino, Martin J. Hoogduijn, Karin Boer, Martijn W. F. van den Hoogen, Carla C. Baan, and Robert C. Minnee. "Nanoparticle Release by Extended Criteria Donor Kidneys During Normothermic Machine Perfusion." Transplantation 103, no. 5 (May 2019): e110-e111. http://dx.doi.org/10.1097/tp.0000000000002642.

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de Vries, Reinier, Siavash Raigani, Padraic Romf, Stephanie EJ Cronin, Casie A. Pendexter, Cailah Carroll, Thomas M. van Gulik, et al. "REAL-TIME VIABILITY ASSESSMENT DURING NORMOTHERMIC MACHINE PERFUSION WITH RAMAN SPECTROSCOPY." Transplantation 104, S3 (September 2020): S252. http://dx.doi.org/10.1097/01.tp.0000699744.73803.88.

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Markgraf, W., M. W. W. Janssen, J. Lilienthal, P. Feistel, C. Thiele, M. Stöckle, and H. Malberg. "Hyperspectral imaging for ex-vivo organ characterization during normothermic machine perfusion." European Urology Supplements 17, no. 2 (March 2018): e767. http://dx.doi.org/10.1016/s1569-9056(18)31366-6.

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Pavel, Mihai-Calin, Constantino Fondevila Campo, David Calatayud Mizrahi, Joana Ferrer Fabrega, Santiago Sanchez Cabus, Víctor Molina Santos, Josep Fuster Obregon, and Juan Carlos Garcia-Valdecasas Salgado. "Normothermic Perfusion Machine in Liver Transplant With Cardiac Death Donor Grafts." Cirugía Española (English Edition) 93, no. 8 (October 2015): 485–91. http://dx.doi.org/10.1016/j.cireng.2015.05.015.

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