Normothermic Machine Perfusion and Inflammatory Mediators Adsorption: First Kidney Transplant Experience.

IF 3.1 3区 医学 Q2 ENGINEERING, BIOMEDICAL
Duilio Pagano, Rosalia Busà, Margot Lo Pinto, Agita Jukna, Ivan Vella, Sergio Calamia, Salvatore Piazza, Paola Salis, Barbara Buscemi, Pier Giulio Conaldi, Valentina Agnese, Massimo Pinzani, Fabrizio di Francesco, Sergio Li Petri, Simone D Scilabra, Salvatore Gruttadauria
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引用次数: 0

Abstract

Kidney transplantation faces challenges due to the shortage of donor organs, leading to the increased use of extended criteria donor (ECD) organs. Recent advancements in ex-situ organ perfusion technologies have facilitated the use of ECD kidneys by preserving organs in near-physiological conditions to tackle ischemia-reperfusion injury (IRI), a process that leads to long-term graft injury. This study focuses on the application of an inflammatory mediators' removal (IMR) integrated in a normothermic machine perfusion (NMP) for the recovery of an ECD kidney before transplantation. This IMR device, designed to adsorb inflammatory molecules, demonstrated effective removal of cytokines during the perfusion process. An ECD kidney underwent 320 minutes of NMP, allowing detailed organ viability assessments and cytokine modulation. A significant volume of urine output and successful post-transplantation outcomes, with no delayed graft function (DGF), highlight the efficacy of this approach. Additionally, the adsorption of inflammatory cytokines was characterized by concentration-dependent removal, suggesting a balanced modulation of both pro- and anti-inflammatory responses. The integration of IMR device into the perfusion process might offer a promising option for evaluating organ viability and mitigating IRI. Further studies are needed to explore the long-term clinical impact of this approach on graft survival and function.

恒温机灌注和炎症介质吸附:首次肾移植经验。
由于供体器官短缺,肾移植面临挑战,导致延长标准供体(ECD)器官的使用增加。离体器官灌注技术的最新进展促进了ECD肾脏的使用,通过在接近生理状态下保存器官来解决缺血-再灌注损伤(IRI),这是一个导致长期移植损伤的过程。本研究的重点是将炎症介质去除(IMR)整合到恒温机器灌注(NMP)中,用于ECD肾移植前的恢复。这种旨在吸附炎症分子的IMR装置在灌注过程中证明了细胞因子的有效去除。一个ECD肾脏进行了320分钟的NMP,允许详细的器官活力评估和细胞因子调节。大量的尿量和成功的移植后结果,没有延迟移植功能(DGF),突出了这种方法的有效性。此外,炎症细胞因子的吸附以浓度依赖性去除为特征,表明促炎和抗炎反应的平衡调节。将IMR装置集成到灌注过程中可能为评估器官活力和减轻IRI提供了一个有希望的选择。需要进一步的研究来探索这种方法对移植物存活和功能的长期临床影响。
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来源期刊
ASAIO Journal
ASAIO Journal 医学-工程:生物医学
CiteScore
6.60
自引率
7.10%
发文量
651
审稿时长
4-8 weeks
期刊介绍: ASAIO Journal is in the forefront of artificial organ research and development. On the cutting edge of innovative technology, it features peer-reviewed articles of the highest quality that describe research, development, the most recent advances in the design of artificial organ devices and findings from initial testing. Bimonthly, the ASAIO Journal features state-of-the-art investigations, laboratory and clinical trials, and discussions and opinions from experts around the world. The official publication of the American Society for Artificial Internal Organs.
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