Developing a porcine slaughterhouse model for normothermic regional perfusion of donor kidneys

Tichelaar, V. (Vera) (2016) Developing a porcine slaughterhouse model for normothermic regional perfusion of donor kidneys. thesis, Medicine.

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Abstract

Objectives: To decrease waiting time for a kidney transplant, donor kidneys of inferior quality are increasingly being accepted. Normothermic regional perfusion (NRP) in donation after circulatory death restores abdominal circulation with autologous blood and improves organ quality. The use of blood in machine perfusion can cause inflammation injury, tissues damage and cell death. Probably, it is better to replace the blood in NRP with an artificial preservation solution. To test the different solutions a normothermic machine perfusion model for an isolated kidney has to be designed. The aim of this study is to design a NMP model with porcine slaughterhouse kidneys to test kidney viability. Methods: Porcine kidneys and autologous whole blood were obtained from the slaughterhouse. Kidneys were transported to our lab and reperfused for 4 hours using the NMP set-up. Seven groups were created (n=1-4). Kidneys were transported differently using cold storage, subnormothermic machineperfusion, oxygenated- or non-oxygenated hypothermic machine perfusion. Warm and cold ischeamic times differ between groups. In one group mannitol, insulin, nutrients and dexamethson was added during NMP (NMP+). Hemodynamics were monitored and perfusate and urine samples were taken regularly. Biopsies were taken to asses renal histology. Results: A stable NMP was established. There was a significant difference between groups. Kidneys preserved using oxygenated hypothermic machine perfusion and reperfused with NMP+ performed significantly better. These kidneys showed better creatinine clearance, sodium reabsorption and urine production than the control group. Conclusion: The model created using oxygenated hypothermic machine perfusion and NMP+ likely is useful for testing different perfusion solutions. However, more research is required to optimize this model

Item Type:	Thesis (Thesis)
Supervisor name:	Faculty supervisor: and Leuvenink, prof. dr. H.G.D. and Daily supervisor: and Venema, L.H. and University Medical Center Groningen and Department of Surgery – Surgical Research Laboratory
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:42
Last Modified:	25 Jun 2020 10:42
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/380

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