Machine perfusion

Machine perfusion

Machine perfusion (MP) is a technique used in organ transplantation as a means of preserving the organs which are to be transplanted. To some degree, it emulates natural perfusion. 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. [cite journal |author=Wight J, Chilcott J, Holmes M, Brewer N |title=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 |journal=Health Technol Assess |year=2003 |pages=1–94 |volume=7 |issue=25 |pmid=14499050]

Hypothermic perfusion has given the longest storage time for canine kidneys with the best result being 8 day storage. [Cohen GL: "8 day kidney preservation", Ch.M. thesis, Liverpool University: 1982.] This experimental model used a storage temperature of 8°C and a Plasma Protein Fraction (PPF) based perfusate. [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.] The octanoic acid content of PPF was found to influence the results of preservation in five-day storage. [Cohen GL, Hunt L, Johnson RWG: "Octanoate toxicity in 5 day kidney preservation", "Cryobiology", vol.20 (1983), p.731.] Both octanoic acid and oleic acid stimulated oxygen consumption to a similar degree during hypothermic perfusion [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.] suggesting that the detrimental effect of Octanoic acid was due to direct metabolic stimulation rather than uncoupling of oxidatative phosphorylation. [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.]

References

Organ transplantation


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