Novosti
Khirurgii

 This journal is
indexed in Scopus
journal cover
android icon Android Applicaion

Year 2018 Vol. 26 No 2

REVIEWS

A.M. FEDORUK

PERFUSION CONDITIONING OF THE LIVER AND KIDNEY ALLOGRAFTS

The Republican Scientific and Practical Center for Organ and Tissue Transplantation,
9th Municipal Clinical Hospital of Minsk,
The Republic of Belarus

Transplantation is the only radical treatment method of terminal stage liver and kidney diseases. Therefore, there has been an increase in the number of transplantations of these organs all over the world and in our country in recent decades. Transplantation success is due to the quality of the donor organ, the clinical status of the recipient before the operation, the time of warm and cold ischemia, the transplantation operation to the recipient, and immunological aspects, but particular importance is attaching to ischemic-reperfusion injury. Static cold preservation determines the development of the ischemia-reperfusion injury of allografts and its severity determines the outcome of the postoperative period.
The review highlights the current state of various variants of machine perfusion of the liver and kidneys. Renewal of interest to perfusion technologies is related to their ability to prevent the ischemia-reperfusion damage, which can be especially important when using donor organs with extended inclusion criteria, the so-called marginal allografts. Hypothermic machine perfusion, subnormothermic machine perfusion, normothermic machine perfusion, controlled heating are used nowadays. The parameters of the perfusion flow of the liver and kidneys were studied. At present, the clinical and economic effectiveness of only hypothermic renal perfusion has been proven. At the same time, the standards of machine perfusion and the protocols of its application are not fully developed and further studies are required.

Keywords: allografts, reperfusion injury, liver, kidney, conditioning methods, perfusion
p. 215-225 of the original issue
References
  1. Ildefonso JA, Arias-Díaz J. Pathophysiology of liver ischemia-reperfusion injury. Cir Esp. 2010 Apr;87(4):202-9. doi: 10.1016/j.ciresp.2009.11.009. [Article in Spanish]
  2. Durand F, Renz JF, Alkofer B, Burra P, Clavien PA, Porte RJ, Freeman RB, Belghiti J. Report of the Paris consensus meeting on expanded criteria donors in liver transplantation. Liver Transpl. 2008 Dec;14(12):1694-707. doi: 10.1002/lt.21668.
  3. Bussutil RW, Klintmalm GK, ed. Transplantation of the liver. 3nd ed. Philadelphia: Elsevier; 2014. 1520 p.
  4. Barshesa NR, Horwitz IB, Franzini L, Vierling JM, Goss JA. Waitlist mortality decreases with increased use of extended criteria donor liver grafts at adult liver transplant centers. Am J Transplant. 2007;7(5):1265-70. doi: 10.1111/j.1600-6143.2007.01758.x.
  5. Nemes B, Gelley F, Zádori G, Piros L, Perneczky J, Kóbori L, Fehérvári I, Görög D. Outcome of liver transplantation based on donor graft quality and recipient status. Transplant Proc. 2010 Jul-Aug;42(6):2327-30. doi: 10.1016/j.transproceed.2010.05.018.
  6. Moers C, Smits JM, Maathuis MH, Treckmann J, van Gelder F, Napieralski BP, van Kasterop-Kutz M, van der Heide JJ, Squifflet JP, van Heurn E, Kirste GR, Rahmel A, Leuvenink HG, Paul A, Pirenne J, Ploeg RJ. Machine perfusion or cold storage in deceased-donor kidney transplantation. N Engl J Med. 2009 Jan 1;360(1):7-19. doi: 10.1056/NEJMoa0802289.
  7. Hoffman A, Burger C, Persky L. Extracorporeal renal storage. Invest Urol. 1965 May;2:567-73.
  8. Carrel A, Lindbergh CA. The culture of whole organs. Science. 1935 Jun 21;81(2112):621-23. doi: 10.1126/science.81.2112.621
  9. Belzer FO, Ashby BS, Gulyassy PF, Powell M. Successful seventeen-hour preservation and transplantation of human-cadaver kidney. N Engl J Med. 1968 Mar 14;278(11):608-10. doi: 10.1056/NEJM196803142781108.
  10. Belzer FO, Ashby BS, Dunphy JE. 24-hour and 72-hour preservation of canine kidneys. Lancet. 1967 Sep 9;2(7515):536-38.
  11. Opelz G, Terasaki PI. Advantage of cold storage over machine perfusion for preservation of cadaver kidneys. Transplantation. 1982 Jan;33(1):64-68.
  12. Collins GM, Bravo-Shugarman M, Terasaki PI. Kidney preservation for transportation. Initial perfusion and 30 hours’ ice storage. Lancet. 1969 Dec 6;2(7632):1219-22. doi: 10.1097/00007890-197009000-00011.
  13. Anaya-Prado R, Delgado-Vázquez JA. Scientific basis of organ preservation. Curr Opin Organ Transplant. 2008 Apr;13(2):129-34. doi: 10.1097/MOT.0b013e3282f6390a.
  14. Southard JH, Belzer FO. Organ preservation. Annu Rev Med. 1995;46:235-47.
  15. Bretschneider HJ. Myocardial protection. Thorac Cardiovasc Surg. 1980 Oct;28(5):295-302. doi: 10.1055/s-2007-1022099.
  16. Ayala-García MA, Pantoja Hernández MÁ, Ramírez-Barba éJ, Soel Encalada JM, González Yebra B. Ch 1: Preservation of renal allografts for transplantation. In: Long L, ed. Renal transplantation – Updates and Advances. 2012. p. 1-16. doi: 10.5772/27231.
  17. Jochmans I, Akhtar MZ, Nasralla D, Kocabayoglu P, Boffa C, Kaisar M, Brat A, O’Callaghan J, Pengel LH, Knight S, Ploeg RJ. Past, Present, and future of dynamic kidney and liver preservation and resuscitation. Am J Transplant. 2016 Sep;16(9):2545-55. doi: 10.1111/ajt.13778.
  18. Pabisiak K, Romanowski M, Myslak M, Szydłowski L, Sieńko J, Domański L, Wisniewska M, Janus T, Sulikowski T, Kempińska A, Kamiński M, Paczkowski M, Mizerski A, Ostrowski M, Ciechanowski K. Variations in temperature of the donor kidney during cold ischemia time and subsequent assessment of reperfusion using the application of thermovision camera. Transplant Proc. 2003 Sep;35(6):2157-59.
  19. Lakey JR, Rajotte RV, Warnock GL, Kneteman NM. Human pancreas reservation prior to islet isolation. Cold ischemic tolerance. Transplantation. 1995 Mar 15;59(5):689-94.
  20. Hoeger S, Lueg G, Tsagogiorgas C, Schneider M, Theisinger S, Theisinger B, Fontana J, Waldherr R, Krämer BK, Schnuelle P, Yard B. UW is superior compared with HTK after prolonged preservation of renal grafts. J Surg Res. 2011 Sep;170(1):e149-57. doi: 10.1016/j.jss.2011.05.020.
  21. Caldwell CC, Tschoep J, Lentsch AB. Lymphocyte function during hepatic ischemia/reperfusion injury. J Leukoc Biol. 2007 Sep;82(3):457-64. doi: 10.1189/jlb.0107062
  22. Hanschen M, Zahler S, Krombach F, Khandoga A. Reciprocal activation between CD4+ T cells and Kupfer cells during hepatic ischemia-reperfusion. Transplantation. 2008;86(5):710-18. doi: 10.1097/TP.0b013e3181821aa7.
  23. Schlegel A, Kron P, Dutkowski P. Hypothermic oxygenated liver perfusion: basic mechanisms and clinical application. Curr Transplant Rep. 2015; 2(1):52-62. doi: 10.1007/s40472-014-0046-1.
  24. Oniscu GC, Randle LV, Muiesan P, Butler AJ, Currie IS, Perera MT, Forsythe JL, Watson CJ. In situ normothermic regional perfusion for controlled donation after circulatory death–the United Kingdom experience. Am J Transplant. 2014 Dec;14(12):2846-54. doi: 10.1111/ajt.12927.
  25. D’Alessandro AM, Southard JH, Love RB, Belzer FO. Organ preservation. Surg Clin North Am. 1994 Oct;74(5):1083-95.
  26. Taylor MJ, Baicu S, Leman B, Greene E, Vazquez A, Brassil J. Twenty-four hour hypothermic machine perfusion preservation of porcine pancreas facilitates processing for islet isolation. Transplant Proc. 2008 Mar;40(2):480-82. doi: 10.1016/j.transproceed.2008.01.004.
  27. Moers C, Pirenne J, Paul A, Ploeg RJ. Machine perfusion or cold storage in deceased-donor kidney transplantation. N Engl J Med. 2012 Feb 23;366(8):770-71. doi: 10.1056/NEJMc1111038.
  28. Groen H, Moers C, Smits JM, Treckmann J, Monbaliu D, Rahmel A, Paul A, Pirenne J, Ploeg RJ, Buskens E. Cost-effectiveness of hypothermic machine preservation versus static cold storage in renal transplantation. Am J Transplant. 2012 Jul;12(7):1824-30. doi: 10.1111/j.1600-6143.2012.04030.x.
  29. Monbaliu D, Brassil J. Machine perfusion of the liver: past, present and future. Curr Opin Organ Transplant. 2010 Apr;15(2):160-66. doi: 10.1097/MOT.0b013e328337342b.
  30. Butler AJ, Randle LV, Watson CJ. Normothermic regional perfusion for donation after circulatory death without prior heparinization. Transplantation. 2014 Jun 27;97(12):1272-78. doi: 10.1097/TP.0000000000000082.
  31. Selzner N, Boehnert M, Selzner M. Preconditioning, postconditioning, and remote conditioning in solid organ transplantation: basic mechanisms and translational applications. Transplant Rev (Orlando). 2012 Apr;26(2):115-24. doi: 10.1016/j.trre.2011.07.003.
  32. Ravikumar R, Jassem W, Mergental H, Heaton N, Mirza D, Perera MT, Quaglia A, Holroyd D, Vogel T, Coussios CC, Friend PJ. Liver transplantation after ex vivo normothermic machine preservation: a phase 1 (first-in-man) clinical nrial. Am J Transplant. 2016 Jun;16(6):1779-87. doi: 10.1111/ajt.13708.
  33. van Golen RF, van Gulik TM, Heger M. Mechanistic overview of reactive species-induced degradation of the endothelial glycocalyx during hepatic ischemia/reperfusion injury. Free Radic Biol Med. 2012 Apr 15;52(8):1382-402. doi: 10.1016/j.freeradbiomed.2012.01.013.
  34. op den Dries S, Karimian N, Sutton ME, Westerkamp AC, Nijsten MW, Gouw AS, Wiersema-Buist J, Lisman T, Leuvenink HG, Porte RJ. Ex vivo normothermic machine perfusion and viability testing of discarded human donor livers. Am J Transplant. 2013 May;13(5):1327-35. doi: 10.1111/ajt.12187.
  35. Weeder PD, van Rijn R, Porte RJ. Machine perfusion in liver transplantation as a tool to prevent non-anastomotic biliary strictures: Rationale, current evidence and future directions. J Hepatol. 2015 Jul;63(1):265-75. doi: 10.1016/j.jhep.2015.03.008.
  36. Schlegel A, Graf R, Clavien PA, Dutkowski P. Hypothermic oxygenated perfusion (HOPE) protects from biliary injury in a rodent model of DCD liver transplantation. J Hepatol. 2013 Nov;59(5):984-91. doi: 10.1016/j.jhep.2013.06.022.
  37. Bruinsma BG, Yeh H, Ozer S, Martins PN, Farmer A, Wu W, Saeidi N, Op den Dries S, Berendsen TA, Smith RN, Markmann JF, Porte RJ, Yarmush ML, Uygun K, Izamis ML. Subnormothermic machine perfusion for ex vivo preservation and recovery of the human liver for transplantation. Am J Transplant. 2014 Jun;14(6):1400-9. doi: 10.1111/ajt.12727.
  38. Gringeri E, Polacco M, D’Amico FE, Scopelliti M, Bassi D, Bonsignore P, Luisetto R, Lodo E, Carraro A, Zanus G, Cillo U. A new liver autotransplantation technique using subnormothermic machine perfusion for organ preservation in a porcine model. Transplant Proc. 2011 May;43(4):997-1000. doi: 10.1016/j.transproceed.2011.01.139.
  39. Liu Q, Nassar A, Farias K, Buccini L, Baldwin W, Mangino M, Mangino M, Bennett A, O’Rourke C, Okamoto T, Uso TD, Fung J, Abu-Elmagd K, Miller C, Quintini C. Sanguineous normothermic machine perfusion improves hemodynamics and biliary epithelial regeneration in donation after cardiac death porcine livers. Liver Transpl. 2014 Aug;20(8):987-99. doi: 10.1002/lt.23906.
  40. Minor T, Efferz P, Fox M, Wohlschlaeger J, Lüer B. Controlled oxygenated rewarming of cold stored liver grafts by thermally graduated machine perfusion prior to reperfusion. Am J Transplant. 2013 Jun;13(6):1450-60. doi: 10.1111/ajt.12235.
  41. Matsuno N, Obara H, Watanabe R, Iwata S, Kono S, Fujiyama M, Hirano T, Kanazawa H, Enosawa S. Rewarming preservation by organ perfusion system for donation after cardiac death liver grafts in pigs. Transplant Proc. 2014 May;46(4):1095-98. doi: 10.1016/j.transproceed.2013.12.035.
  42. Kozaki K, Sakurai E, Uchiyama M, Matsuno N, Kozaki M, Nagao T. Development of hypothermic continuous perfusion preservation machine equipped with nonpulsatile pump and its clinical application. Transplant Proc. 2000 Feb;32(1):5-9.
  43. Divonin AL, Mishchenko BP, Loginova LI, Mikhailova ML. Changes in the liver circulation and kidney function during pulsatile and non-pulsatile perfusion Anesteziol Reanimatol. 1991 May-Jun;(3):36-40. 44. Boon RA, Horrevoets AJ. Key transcriptional regulators of the vasoprotective effects of shear stress. Hamostaseologie. 2009 Jan;29(1):39-40, 41-3.
  44. Sebzda E, Zou Z, Lee JS, Wang T, Kahn ML. Transcription factor KLF2 regulates the migration of naive T cells by restricting chemokine receptor expression patterns. Nat Immunol. 2008 Mar;9(3):292-300. doi: 10.1038/ni1565.
  45. Tullius SG, García-Cardeña G. Organ procurement and perfusion before transplantation. N Engl J Med. 2009 Jan 1;360(1):78-80. doi: 10.1056/NEJMe0809215.
  46. Hart NA, van der Plaats A, Moers C, Leuvenink HG, Wiersema-Buist J, Verkerke GJ, Rakhorst G, Ploeg RJ. Development of the isolated dual perfused rat liver model as an improved reperfusion model for transplantation research. Int J Artif Organs. 2006 Feb;29(2):219-27.
Address for correspondence:
220045, The Republic of Belarus,
Minsk, Semashko Str., 8,
Republican Scientific and Practical
Center for Organ and Tissue Transplantation,
9th Municipal Clinical Hospital, Department of Hepatology and Minimally Invasive Surgery,
Tel.:+375 29 675 12 57,
e-mail: doctorfam@mail.ru,
Fedaruk Aliaksei M.
Information about the authors:
Fedaruk Aliaksei M., MD, Associate Professor, Head of the Department of Hepatology and Minimally Invasive Surgery of Republican Scientific and Practical Center for Organ and Tissue Transplantation, 9th Municipal Clinical Hospital, Minsk, Republic of Belarus.
https://orcid.org/0000-0001-9211-8396
Contacts | ©Vitebsk State Medical University, 2007-2023