Perfusate Biomarker Comparison During Renal Hypothermic and Normothermic Machine Perfusion: Do These Techniques Provide Similar Insights?

IF 5 2区医学 Q1 IMMUNOLOGY

Transplantation Pub Date : 2025-10-01 Epub Date: 2025-06-09 DOI:10.1097/TP.0000000000005440

Tim L Hamelink, Baran Ogurlu, Chris L Jaynes, Veerle A Lantinga, Henri G D Leuvenink, Anna K Keller, Cyril Moers

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引用次数: 0

Abstract

Background: Hypothermic machine perfusion (HMP) and normothermic machine perfusion (NMP) are increasingly used in renal transplantation. Both techniques enable pretransplant organ viability assessment through biomarker measurements in the perfusion solution. This study examines similarities and differences in biomarker release during HMP and NMP, focusing on well-established biomarkers alongside functional markers in porcine and discarded human donor kidneys.

Methods: Discarded human donor kidneys (n = 25) underwent 4 h of oxygenated hypothermic machine perfusion (HMPO 2 ) and subsequently 4 h of NMP. Porcine kidneys were exposed to either minimal warm ischemia or 75 min of warm ischemia (n = 30 per group). Hereafter, kidneys were placed on HMPO 2 for 6 h followed by 6 h of NMP. Flow dynamics were recorded, and the biomarkers aspartate aminotransferase (ASAT), lactate dehydrogenase (LDH), N -acetyl-β-glucosaminidase, tissue inhibitor of metalloproteinases-2 (TIMP-2), and heart-type fatty acid-binding protein were measured longitudinally in the perfusates.

Results: For human kidneys, we found moderate to strong correlations between ASAT, LDH, TIMP-2, and heart-type fatty acid-binding protein content measured during HMPO 2 and the same biomarkers during NMP. In porcine kidneys, clear distinctions between ischemically damaged and healthy kidneys were observed in flow dynamics and content of ASAT, LDH, and TIMP-2 during both HMPO 2 and NMP.

Conclusions: Our findings suggest that biomarker release during HMPO 2 and NMP have similarities, indicating that some biomarkers might already be assessed during HMPO 2 . However, the predictive value of biomarkers in both techniques remains elusive. Additionally, NMP could provide important benefits over HMPO 2 , including functional assessment and reconditioning.

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肾低温和恒温机器灌注时灌注物生物标志物的比较：这些技术是否提供了类似的见解？

背景：低温机器灌注（HMP）和常温机器灌注（NMP）在肾移植中的应用越来越广泛。这两种技术都可以通过灌注溶液中的生物标志物测量来评估移植前器官活力。本研究考察了HMP和NMP期间生物标志物释放的异同，重点关注猪和丢弃的人供肾中已建立的生物标志物和功能标志物。方法：丢弃的人供肾（n = 25）进行4 h的缺氧低温机器灌注（HMPO2）和4 h的NMP。将猪肾脏暴露于轻度热缺血或75分钟的热缺血中（每组n = 30）。随后，将肾脏置于HMPO2上6小时，然后再给予NMP 6小时。记录血流动力学，纵向测定灌注液中生物标志物天冬氨酸转氨酶（ASAT）、乳酸脱氢酶（LDH）、n -乙酰-β-氨基葡萄糖苷酶、金属蛋白酶组织抑制剂-2 （TIMP-2）和心脏型脂肪酸结合蛋白。结果：对于人类肾脏，我们发现在HMPO2期间测量的ASAT、LDH、TIMP-2和心脏型脂肪酸结合蛋白含量与NMP期间测量的相同生物标志物之间存在中度至强相关性。在猪肾脏中，缺血损伤与健康肾脏在HMPO2和NMP期间的血流动力学和ASAT、LDH和TIMP-2的含量有明显的区别。结论：我们的研究结果表明，HMPO2和NMP期间的生物标志物释放具有相似性，表明一些生物标志物可能已经在HMPO2期间被评估。然而，两种技术中生物标志物的预测价值仍然难以捉摸。此外，NMP可以提供比HMPO2更重要的优势，包括功能评估和修复。

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来源期刊

Transplantation 医学-免疫学

CiteScore

8.50

自引率

11.30%

发文量

1906

审稿时长

1 months

期刊介绍： The official journal of The Transplantation Society, and the International Liver Transplantation Society, Transplantation is published monthly and is the most cited and influential journal in the field, with more than 25,000 citations per year. Transplantation has been the trusted source for extensive and timely coverage of the most important advances in transplantation for over 50 years. The Editors and Editorial Board are an international group of research and clinical leaders that includes many pioneers of the field, representing a diverse range of areas of expertise. This capable editorial team provides thoughtful and thorough peer review, and delivers rapid, careful and insightful editorial evaluation of all manuscripts submitted to the journal. Transplantation is committed to rapid review and publication. The journal remains competitive with a time to first decision of fewer than 21 days. Transplantation was the first in the field to offer CME credit to its peer reviewers for reviews completed. The journal publishes original research articles in original clinical science and original basic science. Short reports bring attention to research at the forefront of the field. Other areas covered include cell therapy and islet transplantation, immunobiology and genomics, and xenotransplantation.