Communication Dans Un Congrès Année : 2009

The answer is in machine perfusion: analysis of machine perfusion on donor after cardiac arrest

Résumé

Purpose: The rift between the number of patients waiting for a graft and donations keeps expanding, increasing the pressure for new sources of organs. Deseased after cardiac arrest donors (DCAD) represent such a source. Due to the warm ischemia before preservation, these organs must be preserved using machine perfusion (MP), which improves graft early function. However, to date no analysis of the mechanistic impact of MP versus cold storage (CS) has been established. Methods: We evaluated kidney grafts 3 months after transplantation in Large White pigs, for which warm ischemia was induced 60 minutes before 24h hours of either CS or MP conditions, using UW as preservation solution. Results: After 3 months, kidney function was improved in grafts preserved with MP, as significant decreases were observed in plasma creatinine (209.8±19.4 vs. 459.0±37.0 μmol/L in CS, p<0.01) as well as proteinuria (0.7±0.1 vs. 4.5±0.4 g/24h in CS, p<0.001). MP had a definite impact on survival: 71.4% in MP group vs. 28.6% in CS, as well as graft fibrosis (31.7±5.2 vs. 53.3±2.8% Sirius Red staining in CS, p<0.001) RT-PCR analysis revealed that MP decreased cytotoxicity marker Fas, and inflammatory cytokines TNFα, IL-2, IFNγ and IL-17, denoting a protection from both Th1 and Th17 immune responses. Decreased CD209 denoted lower den- dritic cell invasion. iNOS levels evidence oxidative stress decrease. Downregulation was also evidenced in inflammation markers C3, P selectin and Thrombospondin (Tsp1); pro-injury marker Notch4 as well as fibrinogenesis marker PAI-1, and hypoxic stress marker HIF1α. Conclusion: Machine perfusion on DCAD kidney graft appears to be benefi- cial for a wide range of lesional mechanisms: inflammation, oxidative stress, endothelial activation and fibrinogenesis.

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hal-05099387 , version 1 (05-06-2025)

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  • HAL Id : hal-05099387 , version 1

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Nader Vaziri, Raphaël Thuillier, Frédéric Favreau, Olivier Celhay, Émilie Manguy, et al.. The answer is in machine perfusion: analysis of machine perfusion on donor after cardiac arrest. 14th ESOT Congress, The European Society Of Transplantation Congress (ESOT), Aug 2009, Paris, France. ⟨hal-05099387⟩
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