Controlled Oxygenated Rewarming Compensates for Cold Storage-induced Dysfunction in Kidney Grafts

Area of Science:

• Organ transplantation
• Nephrology
• Surgical innovation

Background:

• Normothermic machine perfusion (NMP) is effective for organ graft preservation but faces logistical challenges, limiting its use.
• Current organ transport relies on hypothermic conditions, reducing NMP's efficacy.
• Controlled warming strategies may mitigate hypothermic damage.

Purpose of the Study:

• To compare controlled oxygenated rewarming (COR) with continuous upfront normothermic perfusion (NMP) for kidney grafts.
• To evaluate the efficacy of COR as a potential alternative to NMP in a porcine transplantation model.

Main Methods:

• Kidneys underwent 30 min warm ischemia, followed by 8h cold storage (CS), 6h cold storage with 2h COR to 35°C, or 8h continuous NMP.
• Kidney function was assessed via a preclinical autotransplant model with 7-day follow-up.

Main Results:

• Both NMP and COR improved renal function compared to CS.
• Serum creatinine and urea levels were similar between NMP and COR groups.
• COR demonstrated reduced tenascin C expression versus CS, indicating less inflammation.

Conclusions:

• COR is a viable alternative for clinical NMP application, offering logistical advantages.
• Gentle rewarming via COR may reduce inflammatory responses in transplanted kidneys.