@article{10902/30906,
year = {2020},
url = {https://hdl.handle.net/10902/30906},
abstract = {Introduction: Post-ischaemic hypothermic machine perfusion (HMP) may be beneficial in recovery of
marginal kidney grafts. The full capacity of conventional HMP (with passive oxygenation) to recondition
an organ has not been realised. We investigated whether HMP can ameliorate ischemic damage caused
by extremely prolonged static cold storage (SCS).
Methods: Porcine kidneys underwent 4-h (SCS4,n ¼ 4) or 52-h (SCS52,n ¼ 4) SCS, followed by 10 h of
HMP and were then subjected to 2 h of isolated normothermic reperfusion (NRP).
Results: There was a post-SCS graft weight loss in SCS52 vs SCS4 kidneys. SCS52 kidneys showed viable
perfusion dynamics during HMP, with significantly shorter times to reach viable parameters vs SCS4
kidneys (p < 0.027). During NRP SCS52 kidneys demonstrated similar trends in perfusion dynamics, renal
function, oxygen consumptions, lactate production, and tubular injury to SCS4 kidneys.
Conclusion: Graft weight loss after SCS, reducing resistance to perfusion, may facilitate better HMP dynamics and graft reconditioning. Clinicians utilising HMP should be aware of this phenomenon when
using HMP in kidneys exposed to extreme periods of SCS. HMP after an extended period of SCS can
resuscitate kidneys to a level equitable of viability as those after a short period of SCS. Utilising passive
oxygenation however may be limiting such recovery and interventions utilising active oxygenation may
provide benefit in such organs.},
publisher = {Elsevier},
publisher = {International Journal of Surgery Open, 2020, 23, 39-47},
title = {Cold ischaemia time: is too long really too bad?. Studies using a porcine kidney ex-vivo reperfusion model},
author = {Hamaoui, Karim and Gowers, Sally and Sandhu, Bynvant and Cook, Terry and Boutelle, Martyn and Casanova Rituerto, Daniel and Papalois, Vassilios},
}