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II: Ex vivo viability testing of kidneys after postmortem warm ischemia
B M Stubenitsky1, M M Booster, L Brasile
1Department of Surgery, University Hospital Maastricht, The Netherlands.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|February 10, 2000
Summary
Ex vivo assessment of kidney viability is possible using exsanguinous metabolic support (EMS) technology. This method evaluates renal metabolism and function during warm preservation, aiding organ donor pool expansion.
Area of Science:
- Transplantation immunology
- Organ preservation
- Renal physiology
Background:
- Expanding the organ donor pool requires improved methods for evaluating marginal and non-heart-beating donors.
- Prospective organ evaluation is crucial for determining viability.
- Warm preservation techniques may offer a window for ex vivo assessment.
Purpose of the Study:
- To investigate the feasibility of using exsanguinous metabolic support (EMS) technology for ex vivo assessment of kidney viability.
- To determine if restored renal metabolism and function can be reliably measured during warm preservation.
Main Methods:
- Kidneys from a bovine model underwent varying durations of warm ischemia (WI) followed by cold ischemia (CI) using ViaSpan.
- Following ischemia, kidneys were perfused at 30-32°C using EMS technology.
- Renal metabolism and function were assessed via oxygen and glucose consumption, urine production, GFR, and hemodynamics.
Main Results:
- EMS technology enabled the assessment of restored renal metabolism and function after WI and CI.
- Key indicators like oxygen consumption, glucose uptake, and urine production reflected organ viability.
- Hemodynamic parameters and glomerular filtration rate provided further insights into kidney function.
Conclusions:
- Ex vivo assessment of kidney viability is feasible using EMS technology during warm preservation.
- This approach can help distinguish between viable and non-viable organs.
- EMS technology shows promise for expanding the organ donor pool by enabling better organ evaluation.