Physiological effects of altering oxygenation during kidney normothermic machine perfusion.

Physiological effects of altering oxygenation during kidney normothermic machine perfusion. Am J Physiol Renal Physiol. 2019 Feb 20;: Authors: Adams TD, Hosgood S, Nicholson ML Abstract Kidney normothermic machine perfusion (NMP) has historically employed a 95% O2/5% CO2 gas mixture. Using a porcine model of organ retrieval, NMP and reperfusion, we tested the hypothesis that reducing perfusate oxygenation (PPO2) would be detrimental to renal function and cause injury. In a minimal-ischemic-injury (MI) experiment, kidneys sustained 10min of warm ischemia (WI) and 2hr of static cold storage (SCS) before 1hr of NMP with either 95%, 25% or 12% O2 with 5% CO2 and N2 balance. In a clinical-injury (CI) model, kidneys with 10min WI and 17hr SCS underwent 1hr of NMP with the above gas combinations, or 18hr SCS as a control. They were then reperfused with whole blood and 95% O2 for 3hr. Overall, reducing PPO2 did not significantly influence renal function in either experiment. Furthermore, there were no differences in injury markers urinary neutrophil gelatinase-associated lipocalin (NGAL) or tissue high motility group box protein 1 (HMGB-1). In the MI experiment, a PPO2 of 25% significantly reduced renal blood flow (RBF) and increased vascular resistance. Oxygen delivery, consumption and extraction (OER) were significantly greater at 95% PPO2. In the CI experiment, RBF was significantly increased at 25% PPO2 and sodium excretion decreased. At...
Source: American Journal of Physiology. Renal Physiology - Category: Physiology Authors: Tags: Am J Physiol Renal Physiol Source Type: research