A simple ex vivo model of human renal allograft preservation using the gonadal vein.

Ries, W P and Marie, Y and Patel, Kiran and Turnbull, C and Smith, T B and Jamil, Nsm and Caldwell, H and Telfer, R and Neil, Dah and Nath, J and Inston, N G (2019) A simple ex vivo model of human renal allograft preservation using the gonadal vein. Annals of the Royal College of Surgeons of England. pp. 1-8. ISSN 1478-7083. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: https://publishing.rcseng.ac.uk/doi/abs/10.1308/rc...

Abstract

INTRODUCTION

Hypothermic machine perfusion, an organ preservation modality, involves flow of chilled preservation fluid through an allograft's vasculature. This study describes a simple, reproducible, human model that allows for interrogation of flow effects during ex vivo organ perfusion.

MATERIALS AND METHODS

Gonadal veins from deceased human renal allografts were subjected to either static cold storage or hypothermic machine perfusion for up to 24 hours. Caspase-3, Krüppel-like factor 2 expression and electron microscopic analysis were compared between 'flow' and 'no-flow' conditions, with living donor gonadal vein sections serving as negative controls.

RESULTS

The increase in caspase-3 expression was less pronounced for hypothermic machine-perfused veins compared with static cold storage (median-fold increase 1.2 vs 2.3; < 0.05). Transmission electron microscopy provided ultrastructural corroboration of endothelial cell apoptosis in static cold storage conditions. For static cold storage preserved veins, Krüppel-like factor 2 expression diminished in a time-dependent manner between baseline and 12 hours ( < 0.05) but was abrogated and reversed by hypothermic machine perfusion ( < 0.05).

CONCLUSIONS

Our methodology is a simple, reproducible and successful model of ex vivo perfusion in the context of human organ preservation. To demonstrate the model's utility, we establish that two widely used markers of endothelial health (caspase-3 and Krüppel-like factor 2) differ between the flow and no-flow conditions of the two predominant kidney preservation modalities. These findings suggest that ex vivo perfusion may mediate the induction of a biochemically favourable endothelial niche which may contribute tohypothermic machine perfusion's association with improved renal transplantation outcomes.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WJ Urogenital system. Urology
Divisions: Clinical Support > Pathology
Emergency Services > Renal
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Depositing User: Mrs Suganthi Vijayaganesh
Date Deposited: 19 Sep 2019 08:02
Last Modified: 19 Sep 2019 08:19
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2399

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