The Impact of Nutritional Supplementation on Donor Kidneys During Oxygenated Ex Vivo Subnormothermic Preservation
Background. Evidence suggests that nutritional supplementation during normothermic ex vivo perfusion improves organ preservation. However, it is unclear whether the same benefit is observed during room temperature (subnormothermic) oxygenated perfusion. In this study, we tested the impact of providi...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2022-10-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001382 |
| _version_ | 1811256809248260096 |
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| author | Rabindra N. Bhattacharjee, PhD Ashley Jackson, MSc Aushanth Ruthirakanthan, BSc Smriti Juriasingani, PhD Max A. Levine, MD Larry Jiang, BSc Ram Patel, BSc Mahms Richard-Mohamed, BSc Sheryl Forrest, BSc Sevanthi Ravichandran Alp Sener, MD, PhD Patrick P. Luke, MD |
| author_facet | Rabindra N. Bhattacharjee, PhD Ashley Jackson, MSc Aushanth Ruthirakanthan, BSc Smriti Juriasingani, PhD Max A. Levine, MD Larry Jiang, BSc Ram Patel, BSc Mahms Richard-Mohamed, BSc Sheryl Forrest, BSc Sevanthi Ravichandran Alp Sener, MD, PhD Patrick P. Luke, MD |
| author_sort | Rabindra N. Bhattacharjee, PhD |
| collection | DOAJ |
| description | Background. Evidence suggests that nutritional supplementation during normothermic ex vivo perfusion improves organ preservation. However, it is unclear whether the same benefit is observed during room temperature (subnormothermic) oxygenated perfusion. In this study, we tested the impact of providing complete nutrition during subnormothermic perfusion on kidney outcomes.
Methods. Porcine kidneys were recovered after 30 min of cross clamping the renal artery in situ to simulate warm ischemic injury. After flushing with preservation solution, paired kidneys were cannulated and randomly assigned to perfusion with either (1) hemoglobin-carrier hemoglobin-based oxygen carrier or (2) hemoglobin-based oxygen carrier + total parenteral nutrition (TPN) for 12 h at 22 °C. To mimic reperfusion injury, all kidneys were reperfused with whole blood for an additional 4 h at 37 °C. Kidney function and damage were assessed.
Results. Kidneys preserved with or without TPN performed equally well, showing similar renal function postreperfusion. Histological findings indicated similar levels of damage from apoptosis staining and acute tubular necrosis scores in both groups. Additionally, markers of renal damage (KIM-1) and inflammation (IL-6; high-mobility group box 1) were similar between the groups.
Conclusions. Unlike other studies using normothermic oxygenated perfusion platforms, nutritional supplementation does not appear to provide any additional benefit during ex vivo kidney preservation over 12 h evaluated by whole blood-based reperfusion method at subnormothermic temperature. Further study should include a kidney autotransplant model to assess the role of TPN in vivo. |
| first_indexed | 2024-04-12T17:46:54Z |
| format | Article |
| id | doaj.art-341b3702dd4f45b5861dd827b9bd1199 |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-04-12T17:46:54Z |
| publishDate | 2022-10-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-341b3702dd4f45b5861dd827b9bd11992022-12-22T03:22:37ZengWolters KluwerTransplantation Direct2373-87312022-10-01810e138210.1097/TXD.0000000000001382202210000-00010The Impact of Nutritional Supplementation on Donor Kidneys During Oxygenated Ex Vivo Subnormothermic PreservationRabindra N. Bhattacharjee, PhD0Ashley Jackson, MSc1Aushanth Ruthirakanthan, BSc2Smriti Juriasingani, PhD3Max A. Levine, MD4Larry Jiang, BSc5Ram Patel, BSc6Mahms Richard-Mohamed, BSc7Sheryl Forrest, BSc8Sevanthi Ravichandran9Alp Sener, MD, PhD10Patrick P. Luke, MD111 Department of Surgery, Schulich Medicine and Dentistry, Western University, London, ON, Canada.3 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.3 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.3 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.4 Multi Organ Transplant Program, London Health Sciences Centre, London, ON, Canada.3 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.3 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.4 Multi Organ Transplant Program, London Health Sciences Centre, London, ON, Canada.4 Multi Organ Transplant Program, London Health Sciences Centre, London, ON, Canada.3 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.1 Department of Surgery, Schulich Medicine and Dentistry, Western University, London, ON, Canada.1 Department of Surgery, Schulich Medicine and Dentistry, Western University, London, ON, Canada.Background. Evidence suggests that nutritional supplementation during normothermic ex vivo perfusion improves organ preservation. However, it is unclear whether the same benefit is observed during room temperature (subnormothermic) oxygenated perfusion. In this study, we tested the impact of providing complete nutrition during subnormothermic perfusion on kidney outcomes. Methods. Porcine kidneys were recovered after 30 min of cross clamping the renal artery in situ to simulate warm ischemic injury. After flushing with preservation solution, paired kidneys were cannulated and randomly assigned to perfusion with either (1) hemoglobin-carrier hemoglobin-based oxygen carrier or (2) hemoglobin-based oxygen carrier + total parenteral nutrition (TPN) for 12 h at 22 °C. To mimic reperfusion injury, all kidneys were reperfused with whole blood for an additional 4 h at 37 °C. Kidney function and damage were assessed. Results. Kidneys preserved with or without TPN performed equally well, showing similar renal function postreperfusion. Histological findings indicated similar levels of damage from apoptosis staining and acute tubular necrosis scores in both groups. Additionally, markers of renal damage (KIM-1) and inflammation (IL-6; high-mobility group box 1) were similar between the groups. Conclusions. Unlike other studies using normothermic oxygenated perfusion platforms, nutritional supplementation does not appear to provide any additional benefit during ex vivo kidney preservation over 12 h evaluated by whole blood-based reperfusion method at subnormothermic temperature. Further study should include a kidney autotransplant model to assess the role of TPN in vivo.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001382 |
| spellingShingle | Rabindra N. Bhattacharjee, PhD Ashley Jackson, MSc Aushanth Ruthirakanthan, BSc Smriti Juriasingani, PhD Max A. Levine, MD Larry Jiang, BSc Ram Patel, BSc Mahms Richard-Mohamed, BSc Sheryl Forrest, BSc Sevanthi Ravichandran Alp Sener, MD, PhD Patrick P. Luke, MD The Impact of Nutritional Supplementation on Donor Kidneys During Oxygenated Ex Vivo Subnormothermic Preservation Transplantation Direct |
| title | The Impact of Nutritional Supplementation on Donor Kidneys During Oxygenated Ex Vivo Subnormothermic Preservation |
| title_full | The Impact of Nutritional Supplementation on Donor Kidneys During Oxygenated Ex Vivo Subnormothermic Preservation |
| title_fullStr | The Impact of Nutritional Supplementation on Donor Kidneys During Oxygenated Ex Vivo Subnormothermic Preservation |
| title_full_unstemmed | The Impact of Nutritional Supplementation on Donor Kidneys During Oxygenated Ex Vivo Subnormothermic Preservation |
| title_short | The Impact of Nutritional Supplementation on Donor Kidneys During Oxygenated Ex Vivo Subnormothermic Preservation |
| title_sort | impact of nutritional supplementation on donor kidneys during oxygenated ex vivo subnormothermic preservation |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001382 |
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