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Updated: May 3, 2026
Use of Ultra-high Field MRI in Small Rodent Models of Polycystic Kidney Disease for In Vivo Phenotyping and Drug Monitoring
Published on: June 23, 2015
DCD pigs' kidneys analyzed by MRI to assess ex vivo their viability
Jean-Bernard Buchs1, Leo Buehler, Solange Moll
11 Research and Development Laboratory, Visceral and Transplantation Service, University Hospital Geneva, Geneva, Switzerland. 2 Research Unit of Surgery, Visceral and Transplantation Service, University Hospital Geneva, Geneva, Switzerland. 3 Department of Pathology, University Hospital Geneva, Geneva, Switzerland. 4 Service of Radiology, University of Geneva, Geneva, Switzerland. 5 Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland. 6 Department of Radiology, University Hospital Geneva, Geneva, Switzerland. 7 Address correspondence to: Jean-Bernard Buchs, MD, Research and Development Laboratory, Visceral and Transplantation Service, University Hospital Geneva, Geneva, Switzerland.
Background:
Magnetic resonance imaging (MRI) gadolinium-perfusion was applied in simulated Donation after Cardiac Death (DCD) in porcine kidneys to measure intrarenal perfusion. Adenosine triphosphate (ATP) resynthesis during oxygenated hypothermic perfusion was compared to evaluate the "ex vivo organ viability". Adenine nucleotide (AN) was measured by P nuclear magnetic resonance (NMR) spectroscopy. Whereas this latter technique requires sophisticated hardware, gadolinium-perfusion can be realized using any standard proton-MRI scanner. The aim of this work was to establish a correlation between the two methods.
Methods:
Twenty-two porcine kidneys presenting up to 90 min warm ischemia were perfused with oxygenation at 4 °C using our magnetic resonance-compatible machine. During the perfusion, P NMR spectroscopy and gadolinium-perfusion sequences were performed. Measures obtained from the gadolinium-perfusion were the speed of elimination of the cortical gadolinium and the presence or absence of a corticomedullar shunt. For ATP resynthesis analysis, P chemical shift imaging was acquired and analyzed. All the kidneys have been submitted to histologic examination.
Results:
ATP resynthesis was observed in all organs presenting a cortical gadolinium elimination slope of (-) 23° or greater. In organs with lower gadolinium elimination, no AN or only precursors were detected. This study reveals a link between the two methods and demonstrates ex vivo viability in 93% of the analyzed kidneys. Benefits and side effects of both methods are discussed.
Conclusion:
Oxygenated hypothermic perfusion enables the evaluation of kidneys in DCD simulated situation; gadolinium-perfusion can be introduced into any center equipped with a proton-MRI scanner allowing results superposable with ATP measurement.
Insights
Magnetic resonance imaging (MRI) gadolinium-perfusion effectively assesses kidney viability after simulated cardiac death, correlating well with adenosine triphosphate (ATP) measurement. This non-invasive technique offers a viable alternative for evaluating ex vivo organ health.
Area of Science:
- Nephrology
- Medical Imaging
- Organ Transplantation
Background:
- Donation after Cardiac Death (DCD) kidney assessment is crucial for transplantation.
- Evaluating ex vivo organ viability is essential for successful transplantation.
- Adenosine triphosphate (ATP) resynthesis is a key indicator of organ viability.
Purpose of the Study:
- To correlate MRI gadolinium-perfusion with P nuclear magnetic resonance (NMR) spectroscopy for assessing ex vivo kidney viability.
- To establish MRI gadolinium-perfusion as a viable alternative to P NMR spectroscopy.
- To evaluate intrarenal perfusion in simulated DCD porcine kidneys.
Main Methods:
- Porcine kidneys underwent oxygenated hypothermic perfusion post-warm ischemia.
- P NMR spectroscopy and MRI gadolinium-perfusion sequences were performed during perfusion.
- Histologic examination was conducted on all kidneys.
Main Results:
- A strong correlation was found between MRI gadolinium-perfusion (elimination slope ≥ -23°) and ATP resynthesis.
- Ex vivo viability was demonstrated in 93% of analyzed kidneys.
- MRI gadolinium-perfusion offers a simpler alternative to P NMR spectroscopy.
Conclusions:
- Oxygenated hypothermic perfusion is effective for evaluating DCD simulated kidneys.
- MRI gadolinium-perfusion is a valuable, accessible tool for assessing ex vivo kidney viability.
- Results from MRI gadolinium-perfusion are comparable to ATP measurements.
