Transplantation Proceedings
Volume 42, Issue 6 , Pages 2020-2023, July 2010

Continuous Real-time Viability Assessment of Kidneys Based on Oxygen Consumption

  • B.P. Weegman

      Affiliations

    • Schulze Diabetes Institute, University of Minnesota, Minneapolis, Minnesota
    • ,
  • V.A. Kirchner

      Affiliations

    • Schulze Diabetes Institute, University of Minnesota, Minneapolis, Minnesota
    • ,
  • W.E. Scott III

      Affiliations

    • Schulze Diabetes Institute, University of Minnesota, Minneapolis, Minnesota
    • ,
  • E.S. Avgoustiniatos

      Affiliations

    • Schulze Diabetes Institute, University of Minnesota, Minneapolis, Minnesota
    • ,
  • T.M. Suszynski

      Affiliations

    • Schulze Diabetes Institute, University of Minnesota, Minneapolis, Minnesota
    • ,
  • J. Ferrer-Fabrega

      Affiliations

    • Schulze Diabetes Institute, University of Minnesota, Minneapolis, Minnesota
    • ,
  • M.D. Rizzari

      Affiliations

    • Schulze Diabetes Institute, University of Minnesota, Minneapolis, Minnesota
    • University of Texas Southwestern Medical Center Department of Surgery, Dallas, Texas
    • ,
  • L.S. Kidder

      Affiliations

    • Schulze Diabetes Institute, University of Minnesota, Minneapolis, Minnesota
    • ,
  • R. Kandaswamy

      Affiliations

    • Department of Surgery, University of Minnesota, Minneapolis, Minnesota
    • ,
  • D.E.R. Sutherland

      Affiliations

    • Schulze Diabetes Institute, University of Minnesota, Minneapolis, Minnesota
    • ,
  • K.K. Papas

      Affiliations

    • Schulze Diabetes Institute, University of Minnesota, Minneapolis, Minnesota
    • Corresponding Author InformationAddress reprint requests to K.K. Papas, PhD, Schulze Diabetes Institute, Department of Surgery, University of Minnesota, 424 Harvard St. SE, Rm. 421 Minneapolis, MN 55455

Abstract 

Background

Current ex vivo quality assessment of donor kidneys is limited to vascular resistance measurements and histological analysis. New techniques for the assessment of organ quality before transplantation may further improve clinical outcomes while expanding the depleted deceased-donor pool. We propose the measurement of whole organ oxygen consumption rate (WOOCR) as a method to assess the quality of kidneys in real time before transplantation.

Methods

Five porcine kidneys were procured using a donation after cardiac death (DCD) model. The renal artery and renal vein were cannulated and the kidney connected to a custom-made hypothermic machine perfusion (HMP) system equipped with an inline oxygenator and fiber-optic oxygen sensors. Kidneys were perfused at 8°C, and the perfusion parameters and partial oxygen pressures (pO2) were measured to calculate WOOCR.

Results

Without an inline oxygenator, the pO2 of the perfusion solution at the arterial inlet and venous outlet diminished to near 0 within minutes. However, once adequate oxygenation was provided, a significant pO2 difference was observed and used to calculate the WOOCR. The WOOCR was consistently measured from presumably healthy kidneys, and results suggest that it can be used to differentiate between healthy and purposely damaged organs.

Conclusions

Custom-made HMP systems equipped with an oxygenator and inline oxygen sensors can be applied for WOOCR measurements. We suggest that WOOCR is a promising approach for the real-time quality assessment of kidneys and other organs during preservation before transplantation.

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 Supported by grants from the National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases (R43 DK070400), the Schott Foundation, the Carol Olson Memorial Diabetes Research Fund, the United Metal Traders, the Eunice L. Dwan Trust, the Iacocca Family Foundation, and Tom and Meredith Olson.

PII: S0041-1345(10)00747-5

doi:10.1016/j.transproceed.2010.05.082

Transplantation Proceedings
Volume 42, Issue 6 , Pages 2020-2023, July 2010

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