Machine perfusion

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Overview

Machine perfusion (MP) is a technique used in organ transplantation as a means of preserving the organs which are to be transplanted. So far it has mainly been used in kidney transplantation. It is an alternative to cold storage (CS). Its clinical and cost-effectiveness are still subject to research.[1]

Hypothermic perfusion has given the longest storage time for canine kidneys with the best result being 8 day storage.[2] This experimental model used a storage temperature of 8°C and a Plasma Protein Fraction (PPF) based perfusate.[3] The octanoic acid content of PPF was found to influence the results of preservation in five-day storage.[4] Both octanoic acid and oleic acid stimulated oxygen consumption to a similar degree during hypothermic perfusion[5] suggesting that the detrimental effect of Octanoic acid was due to direct metabolic stimulation rather than uncoupling of oxidatative phosphorylation.[6]

References

  1. Wight J, Chilcott J, Holmes M, Brewer N (2003). "The clinical and cost-effectiveness of pulsatile machine perfusion versus cold storage of kidneys for transplantation retrieved from heart-beating and non-heart-beating donors". Health Technol Assess. 7 (25): 1–94. PMID 14499050.
  2. Cohen GL: 8 day kidney preservation, Ch.M. thesis, Liverpool University: 1982.
  3. Cohen GL, Johnson RWG: "Perfusate buffering for 8-day canine kidney storage", Proceedings of the European Society for Artificial Organs, vol.7 (1980), p.235-239.
  4. Cohen GL, Hunt L, Johnson RWG: "Octanoate toxicity in 5 day kidney preservation", Cryobiology, vol.20 (1983), p.731.
  5. Cohen GL, Burdett K, Johnson RWG: "Stimulation of oxygen consumption by oleic and octanoic acid during hypothermic kidney preservation", Cryobiology, vol.22 (1985), p.615-616.
  6. Cohen GL, Burdett K, Hunt L, Johnson RWG: "Uncoupling of oxidative phosphorylation by octanoic acid during 5-day hypothermic kidney preservation", Cryobiology, vol.21 (1984), p.699-700.

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