Open AccessDevelopment of ex situ normothermic reperfusion as an innovative method to assess pancreases after preservation
Author(s) -
Ogbemudia Ann Etohan,
Hakim Gabriella,
Dengu Fungai,
ElGilani Faysal,
Dumbill Richard,
Mulvey John,
Sayal Karen,
Prudhomme Thomas,
Mesnard Benoit,
Rozenberg Kaithlyn,
Lo Faro Letizia,
James Timothy,
Oliver Joshua,
Sharples Edward,
Mittal Shruti,
Johnson Paul,
Friend Peter J.,
Ploeg Rutger,
Hunter James,
Branchereau Julien
Publication year - 2021
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13990
Subject(s) - machine perfusion , medicine , cold storage , perfusion , transplantation , viaspan , surgery , cardiology , liver transplantation , biology , horticulture
Summary Static cold storage (SCS) is the standard method for pancreas preservation prior to transplantation; however, it does not permit organ assessment. Normothermic reperfusion (NR) is utilized clinically for other organs to assess viability. Our aim was to develop NR using normothermic machine perfusion technique to simulate reperfusion at the time of transplantation, enabling evaluation of oxygenated hypothermic machine perfusion (HMPO2) as a newer strategy to optimize pancreas preservation. 13 porcine pancreases procured after circulatory death were divided into 3 groups: 4 pancreases preserved using SCS, and 2 groups preserved by HMPO2 ( n = 4 and n = 5, differing by type of preservation solution). Duration of perfusion or cold storage was 6 hours before the 1‐hour assessment using NR. Outcome measures were perfusion characteristics, biochemistry and change in tissue water mass as oedema assessment. During NR, the HMPO2 groups demonstrated better perfusion characteristics, normal macroscopic appearances, decreased water mass and one HMPO2 group demonstrated a response to glucose stimulation. Conversely, the SCS group showed an increased water mass and developed early macroscopic appearances of oedema, interstitial haemorrhage and minimal portal outflow. This study suggests that ex situ assessment of pancreases by NR is promising, and that HMPO2 may be better than SCS.