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Journal of Transplantation
Volume 2013 (2013), Article ID 802618, 7 pages
http://dx.doi.org/10.1155/2013/802618
Research Article

Hypothermic Machine Perfusion Preservation of the DCD Kidney: Machine Effects

1Departments of Surgery, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond, VA 23298-0454, USA
2Functional Circulation, Northbrook, IL 60062, USA
3Emergency Medicine, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond, VA 23298-0454, USA
4Physiology and Biophysics, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond, VA 23298-0454, USA

Received 10 July 2013; Accepted 9 September 2013

Academic Editor: Parmjeet Randhawa

Copyright © 2013 Susanne L. Lindell et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. Kidneys from DCD donors represent a significant pool, but preservation problems exist. The study objective was to test the importance of machine type for hypothermic preservation of DCD kidneys. Methods. Adult Beagle dog kidneys underwent 45 minutes of warm in situ ischemia followed by hypothermic perfusion for 24 hours (Belzer-MPS Solution) on either an ORS LifePort or a Waters RM3 using standard perfusion protocols. Kidneys were then autotransplanted, and renal function was assessed over 7 days following contralateral nephrectomy. Results. Renal vascular resistance was not different between the two pumps. After 24 hours, the oxygen partial pressure and oxygen delivery in the LifePort perfusate were significantly lower than those in the RM3 but not low enough to change lactate production. TheLifePort ran significantly colder than RM3 (2° versus 5°C). The arterial pressure waveform of the RM3 was qualitatively different from the waveform of the LifePort. Preservation injury after transplantation was not different between the devices. When the LifePort was changed to nonpulsatile flow, kidneys displayed significantly greater preservation injury compared to RM3. Conclusions. Both LifePort and RM3 can be used for hypothermic machine perfusion preservation of DCD kidneys with equal outcomes as long as the duty cycle remains pulsatile.