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Machine perfusion in solid organ transplantation: where is the benefit?

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Abstract

Background

Machine perfusion (MP) in solid organ transplantation has been a topic of variable importance for decades. At the dawn of organ transplantation, MP was one of the standard techniques for preservation; today’s gold standard for organ preservation for transplantation is cold storage (CS). The outcome after transplantation of solid organs has tremendously improved over the last five decades. MP has been continuously under investigation and may be an option for organ preservation in selected cases; however, there is only little evidence from clinical trials that can be used to advocate for MP as a routine organ preservation method.

Methods

This article reviews the current knowledge on MP in the field of solid organ transplantation with special focus on findings from clinical trials.

Conclusion

Especially in heart and lung transplantation, MP seems to be a promising tool to improve postoperative outcome, but a general evidence-based recommendation for or against an application of MP cannot be given due to the lack of the highest level of clinical evidence. Gold standards such as CS should not be left behind without good reason. Randomized clinical trials are desperately needed to further improve outcome and for better understanding of the underlying pathophysiological mechanisms.

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References

  1. Le Gallois CJJ (1812) Expériences sur le principe de la vie: notamment sur celui des mouvements du coeur, et sur le siége de ce principe. D’Hautel

  2. Carrel A, Lindbergh CA (1935) The culture of whole organs. Science 81(2112):621–623. doi:10.1126/science.81.2112.621

    Article  CAS  PubMed  Google Scholar 

  3. Malinin TI (1996) Remembering Alexis Carrel and Charles A. Lindbergh. Tex Heart Inst J 23(1):28–35

    CAS  PubMed Central  PubMed  Google Scholar 

  4. Moore TC, English TS, Berne TV (1974) Machine preservation of 302 human cadaveric kidneys for transplantation. Surg Gynecol Obstet 138(2):239–243

    CAS  PubMed  Google Scholar 

  5. Stephenson TP, Hendry WF, Ward JP, Wickham JE (1975) Continuous perfusion of human cadaveric kidneys for transplantation. Br J Urol 47(1):37–44

    Article  CAS  PubMed  Google Scholar 

  6. Stephenson TP, O’Donoghue EP, Hendry WF, Wickham JE (1973) Preservation of human kidneys for transplantation: preliminary results with a Gambro perfusion machine. Br Med J 1(5850):379–381

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Opelz G, Terasaki PI (1976) Kidney preservation: perfusion versus cold storage—1975. Transplant Proc 8(1):121–125

    CAS  PubMed  Google Scholar 

  8. Opelz G, Terasaki PI (1982) Advantage of cold storage over machine perfusion for preservation of cadaver kidneys. Transplantation 33(1):64–68

    Article  CAS  PubMed  Google Scholar 

  9. Aberg F, Isoniemi H, Hockerstedt K (2011) Long-term results of liver transplantation. Scand J Surg 100(1):14–21

    PubMed  Google Scholar 

  10. Singh S, Watt KD (2012) Long-term medical management of the liver transplant recipient: what the primary care physician needs to know. Mayo Clin Proc 87(8):779–790. doi:10.1016/j.mayocp.2012.02.021

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Bond M, Pitt M, Akoh J, Moxham T, Hoyle M, Anderson R (2009) The effectiveness and cost-effectiveness of methods of storing donated kidneys from deceased donors: a systematic review and economic model. Health Technol Assess 13 (38):iii–iv, xi–xiv, 1–156. doi:10.3310/hta13380.

  12. Opelz G, Dohler B (2007) Multicenter analysis of kidney preservation. Transplantation 83(3):247–253. doi:10.1097/01.tp.0000251781.36117.27

    Article  PubMed  Google Scholar 

  13. Wight JP, Chilcott JB, Holmes MW, Brewer N (2003) Pulsatile machine perfusion vs. cold storage of kidneys for transplantation: a rapid and systematic review. Clin Transplant 17(4):293–307

    Article  PubMed  Google Scholar 

  14. Belzer FO, Ashby BS, Huang JS, Dunphy JE (1968) Etiology of rising perfusion pressure in isolated organ perfusion. Ann Surg 168(3):382–391

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Jochmans I, Pirenne J (2011) Graft quality assessment in kidney transplantation: not an exact science yet! Curr Opin Organ Transplant 16(2):174–179. doi:10.1097/MOT.0b013e3283446b31

    Article  CAS  PubMed  Google Scholar 

  16. Jochmans I, Moers C, Smits JM, Leuvenink HG, Treckmann J, Paul A, Rahmel A, Squifflet JP, van Heurn E, Monbaliu D, Ploeg RJ, Pirenne J (2011) The prognostic value of renal resistance during hypothermic machine perfusion of deceased donor kidneys. Am J Transplant 11(10):2214–2220. doi:10.1111/j.1600-6143.2011.03685.x

    Article  CAS  PubMed  Google Scholar 

  17. Nagelschmidt M, Minor T, Gallinat A, Moers C, Jochmans I, Pirenne J, Ploeg RJ, Paul A, Treckmann J (2012) Lipid peroxidation products in machine perfusion of older donor kidneys. J Surg Res. doi:10.1016/j.jss.2012.04.071

    PubMed  Google Scholar 

  18. Tulipan JE, Stone J, Samstein B, Kato T, Emond JC, Henry SD, Guarrera JV (2011) Molecular expression of acute phase mediators is attenuated by machine preservation in human liver transplantation: preliminary analysis of effluent, serum, and liver biopsies. Surgery 150(2):352–360. doi:10.1016/j.surg.2011.06.003

    Article  PubMed  Google Scholar 

  19. Patel SK, Pankewycz OG, Nader ND, Zachariah M, Kohli R, Laftavi MR (2012) Prognostic utility of hypothermic machine perfusion in deceased donor renal transplantation. Transplant Proc 44(7):2207–2212. doi:10.1016/j.transproceed.2012.07.129

    Article  CAS  PubMed  Google Scholar 

  20. Moers C, Pirenne J, Paul A, Ploeg RJ (2012) Machine perfusion or cold storage in deceased-donor kidney transplantation. N Engl J Med 366(8):770–771. doi:10.1056/NEJMc1111038

    Article  CAS  PubMed  Google Scholar 

  21. Warnecke G, Moradiellos J, Tudorache I, Kuhn C, Avsar M, Wiegmann B, Sommer W, Ius F, Kunze C, Gottlieb J, Varela A, Haverich A (2012) Normothermic perfusion of donor lungs for preservation and assessment with the Organ Care System Lung before bilateral transplantation: a pilot study of 12 patients. Lancet. doi:10.1016/S0140-6736(12)61344-0

    PubMed  Google Scholar 

  22. Alijani MR, Cutler JA, DelValle CJ, Morres DN, Fawzy A, Pechan BW, Helfrich GB (1985) Single-donor cold storage versus machine perfusion in cadaver kidney preservation. Transplantation 40(6):659–661

    Article  CAS  PubMed  Google Scholar 

  23. Guarrera JV, Henry SD, Chen SW, Brown T, Nachber E, Arrington B, Boykin J, Samstein B, Brown RS Jr, Emond JC, Lee HT (2011) Hypothermic machine preservation attenuates ischemia/reperfusion markers after liver transplantation: preliminary results. J Surg Res 167(2):e365–e373. doi:10.1016/j.jss.2010.01.038

    Article  PubMed  Google Scholar 

  24. Guarrera JV, Polyak M, O’Mar Arrington B, Kapur S, Stubenbord WT, Kinkhabwala M (2004) Pulsatile machine perfusion with Vasosol solution improves early graft function after cadaveric renal transplantation. Transplantation 77(8):1264–1268

    Article  PubMed  Google Scholar 

  25. Moers C, Smits JM, Maathuis MH, Treckmann J, van Gelder F, Napieralski BP, van Kasterop-Kutz M, van der Heide JJ, Squifflet JP, van Heurn E, Kirste GR, Rahmel A, Leuvenink HG, Paul A, Pirenne J, Ploeg RJ (2009) Machine perfusion or cold storage in deceased-donor kidney transplantation. N Engl J Med 360(1):7–19. doi:10.1056/NEJMoa0802289

    Article  CAS  PubMed  Google Scholar 

  26. van der Vliet JA, Kievit JK, Hene RJ, Hilbrands LB, Kootstra G (2001) Preservation of non-heart-beating donor kidneys: a clinical prospective randomised case–control study of machine perfusion versus cold storage. Transplant Proc 33(1–2):847

    Article  PubMed  Google Scholar 

  27. Watson CJ, Wells AC, Roberts RJ, Akoh JA, Friend PJ, Akyol M, Calder FR, Allen JE, Jones MN, Collett D, Bradley JA (2010) Cold machine perfusion versus static cold storage of kidneys donated after cardiac death: a UK multicenter randomized controlled trial. Am J Transplant 10(9):1991–1999. doi:10.1111/j.1600-6143.2010.03165.x

    Article  CAS  PubMed  Google Scholar 

  28. Marshall VC, Ross H, Scott DF, McInnes S, Thomson N, Atkins RC, Mathew TH, Kincaid-Smith PS (1977) Preservation of cadaver of renal allografts: comparison of ice storage and machine perfusion. Med J Aust 2(11):353–356

    CAS  PubMed  Google Scholar 

  29. Sheil AG, Drummond JM, Rogers JH, Boulas J, May J, Storey BG (1975) A controlled clinical trial of machine perfusion of cadaveric donor renal allografts. Lancet 2(7929):287–290

    Article  CAS  PubMed  Google Scholar 

  30. McCurry K, Jeevanandam V, Mihaljevic T, Couper G, Elanwar M, Saleh H, Ardehali A (2008) The 1-year follow-up results of the PROTECT patient population using the organ care system. J Heart Lung Transplant 27 (2). doi:10.1016/j.healun.2007.11.302

  31. McCurry K, Jeevanandam V, Mihaljevic T, Couper G, Elanwar M, Saleh H, Ardehali A (2008) Prospective multi-center safety and effectiveness evaluation of the organ care system device for cardiac use (PROCEED). J Heart Lung Transplant 27(2). doi:10.1016/j.healun.2007.11.302

  32. Lee CY, Mangino MJ (2009) Preservation methods for kidney and liver. Organogenesis 5(3):105–112

    Article  PubMed Central  PubMed  Google Scholar 

  33. Monbaliu D, Heedfeld V, Liu Q, Wylin T, van Pelt J, Vekemans K, Pirenne J (2011) Hypothermic machine perfusion of the liver: is it more complex than for the kidney? Transplant Proc 43(9):3445–3450. doi:10.1016/j.transproceed.2011.09.033

    Article  CAS  PubMed  Google Scholar 

  34. Treckmann J, Moers C, Smits JM, Gallinat A, Maathuis MH, van Kasterop-Kutz M, Jochmans I, Homan van der Heide JJ, Squifflet JP, van Heurn E, Kirste GR, Rahmel A, Leuvenink HG, Pirenne J, Ploeg RJ, Paul A (2011) Machine perfusion versus cold storage for preservation of kidneys from expanded criteria donors after brain death. Transpl Int 24(6):548–554. doi:10.1111/j.1432-2277.2011.01232.x

    Article  PubMed  Google Scholar 

  35. Buchanan PM, Lentine KL, Burroughs TE, Schnitzler MA, Salvalaggio PR (2008) Association of lower costs of pulsatile machine perfusion in renal transplantation from expanded criteria donors. Am J Transplant 8(11):2391–2401. doi:10.1111/j.1600-6143.2008.02412.x

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  36. Post IC, Dirkes MC, Heger M, Bezemer R, van ’t Leven J, van Gulik TM (2012) Optimal flow and pressure management in machine perfusion systems for organ preservation. Ann Biomed Eng. doi:10.1007/s10439-012-0601-9

    PubMed Central  PubMed  Google Scholar 

  37. Groen H, Moers C, Smits JM, Treckmann J, Monbaliu D, Rahmel A, Paul A, Pirenne J, Ploeg RJ, Buskens E (2012) Cost-effectiveness of hypothermic machine preservation versus static cold storage in renal transplantation. Am J Transplant 12(7):1824–1830. doi:10.1111/j.1600-6143.2012.04030.x

    Article  CAS  PubMed  Google Scholar 

  38. Liu Q, Bruns H, Schultze D, Xue Y, Zorn M, Flechtenmacher C, Straub BK, Rauen U, Schemmer P (2012) HTK-N, a modified HTK solution, decreases preservation injury in a model of microsteatotic rat liver transplantation. Langenbeck’s Arch Surg 397(8):1323–1331. doi:10.1007/s00423-012-1022-9

    Article  Google Scholar 

  39. Cannata A, Botta L, Colombo T, Russo CF, Taglieri C, Bruschi G, Merlanti B, Frigerio M, Martinelli L (2012) Does the cardioplegic solution have an effect on early outcomes following heart transplantation? Eur J Cardiothorac Surg 41(4):e48–e52. doi:10.1093/ejcts/ezr321, discussion e52–43

    Article  PubMed  Google Scholar 

  40. de Boer J, De Meester J, Smits JM, Groenewoud AF, Bok A, van der Velde O, Doxiadis II, Persijn GG (1999) Eurotransplant randomized multicenter kidney graft preservation study comparing HTK with UW and Euro-Collins. Transpl Int 12(6):447–453

    Article  PubMed  Google Scholar 

  41. Loganathan S, Radovits T, Hirschberg K, Korkmaz S, Koch A, Karck M, Szabo G (2010) Effects of Custodiol-N, a novel organ preservation solution, on ischemia/reperfusion injury. J Thorac Cardiovasc Surg 139(4):1048–1056. doi:10.1016/j.jtcvs.2009.09.034

    Article  CAS  PubMed  Google Scholar 

  42. Pizanis N, Petrov A, Heckmann J, Wiswedel I, Wohlschlager J, de Groot H, Jakob H, Rauen U, Kamler M (2012) A new preservation solution for lung transplantation: evaluation in a porcine transplantation model. J Heart Lung Transplant 31(3):310–317. doi:10.1016/j.healun.2011.11.009

    Article  PubMed  Google Scholar 

  43. Stegemann J, Hirner A, Rauen U, Minor T (2010) Use of a new modified HTK solution for machine preservation of marginal liver grafts. J Surg Res 160(1):155–162. doi:10.1016/j.jss.2008.10.021

    Article  CAS  PubMed  Google Scholar 

  44. Polyak MM, Grosche A (2008) Comparison of Vasosol and University of Wisconsin solutions on early kidney function after 24 h of cold ischemia in a canine autotransplantation model. J Surg Res 150(2):255–260. doi:10.1016/j.jss.2007.11.727

    Article  CAS  PubMed  Google Scholar 

  45. Bae C, Henry SD, Guarrera JV (2012) Is extracorporeal hypothermic machine perfusion of the liver better than the ‘good old icebox’? Curr Opin Organ Transplant 17(2):137–142. doi:10.1097/MOT.0b013e328351083d

    Article  PubMed  Google Scholar 

  46. Vekemans K, van Pelt J, Komuta M, Wylin T, Heedfeld V, Detry O, Monbaliu D, Pirenne J (2011) Attempt to rescue discarded human liver grafts by end ischemic hypothermic oxygenated machine perfusion. Transplant Proc 43(9):3455–3459. doi:10.1016/j.transproceed.2011.09.029

    Article  CAS  PubMed  Google Scholar 

  47. Xu H, Berendsen T, Kim K, Soto-Gutierrez A, Bertheium F, Yarmush ML, Hertl M (2012) Excorporeal normothermic machine perfusion resuscitates pig DCD livers with extended warm ischemia. J Surg Res 173(2):e83–e88. doi:10.1016/j.jss.2011.09.057

    Article  PubMed Central  PubMed  Google Scholar 

  48. Luer B, Koetting M, Efferz P, Minor T (2010) Role of oxygen during hypothermic machine perfusion preservation of the liver. Transpl Int 23(9):944–950. doi:10.1111/j.1432-2277.2010.01067.x

    PubMed  Google Scholar 

  49. Saad S, Minor T (2008) Short-term resuscitation of predamaged donor livers by brief machine perfusion: the influence of temperature. Transplant Proc 40(10):3321–3326. doi:10.1016/j.transproceed.2008.06.058

    Article  CAS  PubMed  Google Scholar 

  50. Lauschke H, Olschewski P, Tolba R, Schulz S, Minor T (2003) Oxygenated machine perfusion mitigates surface antigen expression and improves preservation of predamaged donor livers. Cryobiology 46(1):53–60

    Article  PubMed  Google Scholar 

  51. Gringeri E, Bonsignore P, Bassi D, D’Amico FE, Mescoli C, Polacco M, Buggio M, Luisetto R, Boetto R, Noaro G, Ferrigno A, Boncompagni E, Freitas I, Vairetti MP, Carraro A, Neri D, Cillo U (2012) Subnormothermic machine perfusion for non-heart-beating donor liver grafts preservation in a Swine model: a new strategy to increase the donor pool? Transplant Proc 44(7):2026–2028. doi:10.1016/j.transproceed.2012.06.014

    Article  CAS  PubMed  Google Scholar 

  52. Fondevila C, Hessheimer AJ, Maathuis MH, Munoz J, Taura P, Calatayud D, Leuvenink H, Rimola A, Garcia-Valdecasas JC, Ploeg RJ (2012) Hypothermic oxygenated machine perfusion in porcine donation after circulatory determination of death liver transplant. Transplantation 94(1):22–29. doi:10.1097/TP.0b013e31825774d7

    Article  CAS  PubMed  Google Scholar 

  53. Shigeta T, Matsuno N, Obara H, Mizunuma H, Kanazawa H, Tanaka H, Fukuda A, Sakamoto S, Kasahara M, Uemoto S, Enosawa S (2012) Functional recovery of donation after cardiac death liver graft by continuous machine perfusion preservation in pigs. Transplant Proc 44(4):946–947. doi:10.1016/j.transproceed.2012.01.078

    Article  CAS  PubMed  Google Scholar 

  54. Bruns H, Watanpour I, Gebhard MM, Flechtenmacher C, Galli U, Schulze-Bergkamen H, Zorn M, Büchler MW, Schemmer P (2011) Glycine and taurine equally prevent fatty livers from Kupffer cell-dependent injury: an in vivo microscopy study. Microcirculation 18(3):205–213. doi:10.1111/j.1549-8719.2010.00078.x

    Article  CAS  PubMed  Google Scholar 

  55. Liang R, Bruns H, Kincius M, Lin T, Ludwig J, Dei-Anane G, Guan X, Gebhard MM, Büchler MW, Schemmer P (2009) Danshen protects liver grafts from ischemia/reperfusion injury in experimental liver transplantation in rats. Transpl Int 22(11):1100–1109. doi:10.1111/j.1432-2277.2009.00925.x

    Article  PubMed  Google Scholar 

  56. Schindler G, Kincius M, Liang R, Backhaus J, Zorn M, Flechtenmacher C, Gebhard MM, Büchler MW, Schemmer P (2009) Fundamental efforts toward the development of a therapeutic cocktail with a manifold ameliorative effect on hepatic ischemia/reperfusion injury. Microcirculation 16(7):593–602. doi:10.1080/10739680903110779

    Article  CAS  PubMed  Google Scholar 

  57. Florack G, Sutherland DE, Heil J, Squifflet JP, Najarian JS (1983) Preservation of canine segmental pancreatic autografts: cold storage versus pulsatile machine perfusion. J Surg Res 34(5):493–504

    Article  CAS  PubMed  Google Scholar 

  58. Leeser DB, Bingaman AW, Poliakova L, Shi Q, Gage F, Bartlett ST, Farney AC (2004) Pulsatile pump perfusion of pancreata before human islet cell isolation. Transplant Proc 36(4):1050–1051. doi:10.1016/j.transproceed.2004.04.041

    Article  CAS  PubMed  Google Scholar 

  59. Taylor MJ, Baicu S, Greene E, Vazquez A, Brassil J (2010) Islet isolation from juvenile porcine pancreas after 24-h hypothermic machine perfusion preservation. Cell Transplant 19(5):613–628. doi:10.3727/096368910X486316

    Article  PubMed  Google Scholar 

  60. Taylor MJ, Baicu S, Leman B, Greene E, Vazquez A, Brassil J (2008) Twenty-four-hour hypothermic machine perfusion preservation of porcine pancreas facilitates processing for islet isolation. Transplant Proc 40(2):480–482. doi:10.1016/j.transproceed.2008.01.004

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  61. Hamed A, Tsui S, Huber J, Lin R, Poggio EC, Ardehali A (2009) Serum lactate is a highly sensitive and specific predictor of post cardiac transplant outcomes using the organ care system. J Heart Lung Transplant 28(2):S71. doi:10.1016/j.healun.2008.11.025

    Article  Google Scholar 

  62. Yeter R, Hübler M, Pasic M, Hetzer R, Knosalla C (2011) Organ preservation with the organ care system. Appl Cardiopulm Pathophysiol 15:207–212

    Google Scholar 

  63. Steen S, Sjoberg T, Pierre L, Liao Q, Eriksson L, Algotsson L (2001) Transplantation of lungs from a non-heart-beating donor. Lancet 357(9259):825–829. doi:10.1016/S0140-6736(00)04195-7

    Article  CAS  PubMed  Google Scholar 

  64. Cypel M, Keshavjee S (2012) The clinical potential of ex vivo lung perfusion. Expert Rev Respir Med 6(1):27–35. doi:10.1586/ers.11.93

    Article  PubMed  Google Scholar 

  65. Cypel M, Yeung JC, Liu M, Anraku M, Chen F, Karolak W, Sato M, Laratta J, Azad S, Madonik M, Chow CW, Chaparro C, Hutcheon M, Singer LG, Slutsky AS, Yasufuku K, de Perrot M, Pierre AF, Waddell TK, Keshavjee S (2011) Normothermic ex vivo lung perfusion in clinical lung transplantation. N Engl J Med 364(15):1431–1440. doi:10.1056/NEJMoa1014597

    Article  CAS  PubMed  Google Scholar 

  66. Cypel M, Liu M, Rubacha M, Yeung JC, Hirayama S, Anraku M, Sato M, Medin J, Davidson BL, de Perrot M, Waddell TK, Slutsky AS, Keshavjee S (2009) Functional repair of human donor lungs by IL-10 gene therapy. Sci Transl Med 1(4):4ra9. doi:10.1126/scitranslmed.3000266

    PubMed  Google Scholar 

  67. Hajjar G, Toledo-Pereyra LH, Mackenzie GH (1986) Effect of 24-hour preservation with oxygen free radical scavengers on isolated-perfused canine heart-lungs. P R Health Sci J 5(1):19–25

    CAS  PubMed  Google Scholar 

  68. Nakajima D, Chen F, Yamada T, Sakamoto J, Osumi A, Fujinaga T, Shoji T, Sakai H, Bando T, Date H (2011) Hypothermic machine perfusion ameliorates ischemia-reperfusion injury in rat lungs from non-heart-beating donors. Transplantation 92(8):858–863. doi:10.1097/TP.0b013e31822d8778

    Article  PubMed  Google Scholar 

  69. Nakajima D, Chen F, Okita K, Motoyama H, Hijiya K, Ohsumi A, Sakamoto J, Yamada T, Sato M, Aoyama A, Bando T, Date H (2012) Reconditioning lungs donated after cardiac death using short-term hypothermic machine perfusion. Transplantation. doi:10.1097/TP.0b013e31826f632e

    PubMed  Google Scholar 

  70. Guan X, Dei-Anane G, Bruns H, Chen J, Nickkholgh A, Liang R, Gross ML, Kern M, Ludwig J, Büchler MW, Schemmer P (2009) Danshen protects kidney grafts from ischemia/reperfusion injury after experimental transplantation. Transpl Int 22(2):232–241. doi:10.1111/j.1432-2277.2008.00770.x

    Article  PubMed  Google Scholar 

  71. Li Z, Nickkholgh A, Yi X, Bruns H, Gross ML, Hoffmann K, Mohr E, Zorn M, Büchler MW, Schemmer P (2009) Melatonin protects kidney grafts from ischemia/reperfusion injury through inhibition of NF-kB and apoptosis after experimental kidney transplantation. J Pineal Res 46(4):365–372. doi:10.1111/j.1600-079X.2009.00672.x

    Article  CAS  PubMed  Google Scholar 

  72. Cekauskas A, Bruns H, Manikas M, Herr I, Gross ML, Zorn M, Jankevicius F, Strupas K, Schemmer P (2013) Sulforaphane decreases kidney injury after transplantation in rats: role of mitochondrial damage. Ann Transplant 18:488–496. doi:10.12659/AOT.884013

    Article  PubMed  Google Scholar 

  73. Minor T, Paul A (2013) Hypothermic reconditioning in organ transplantation. Curr Opin Organ Transplant 18(2):161–167. doi:10.1097/MOT.0b013e32835e29de

    Article  CAS  PubMed  Google Scholar 

  74. Minor T, Koetting M, Kaiser G, Efferz P, Luer B, Paul A (2011) Hypothermic reconditioning by gaseous oxygen improves survival after liver transplantation in the pig. Am J Transplant 11(12):2627–2634. doi:10.1111/j.1600-6143.2011.03731.x

    Article  CAS  PubMed  Google Scholar 

  75. Minor T, Stegemann J, Hirner A, Koetting M (2009) Impaired autophagic clearance after cold preservation of fatty livers correlates with tissue necrosis upon reperfusion and is reversed by hypothermic reconditioning. Liver Transpl 15(7):798–805. doi:10.1002/lt.21751

    Article  PubMed  Google Scholar 

  76. Tolba RH, Akbar S, Puetz U, Minor T (2000) Use and limitations of reconditioning ischemically damaged livers from non-heart-beating donors by venous oxygen persufflation. Transplant Proc 32(7):2118–2119

    Article  CAS  PubMed  Google Scholar 

  77. Yagi S, Nagai K, Kadaba P, Afify M, Teramukai S, Uemoto S, Tolba RH (2013) A novel organ preservation for small partial liver transplantations in rats: venous systemic oxygen persufflation with nitric oxide gas. Am J Transplant 13(1):222–228. doi:10.1111/j.1600-6143.2012.04310.x

    Article  CAS  PubMed  Google Scholar 

  78. Gallinat A, Paul A, Efferz P, Luer B, Kaiser G, Wohlschlaeger J, Treckmann J, Minor T (2012) Hypothermic reconditioning of porcine kidney grafts by short-term preimplantation machine perfusion. Transplantation 93(8):787–793. doi:10.1097/TP.0b013e3182492201

    Article  CAS  PubMed  Google Scholar 

  79. Koetting M, Frotscher C, Minor T (2010) Hypothermic reconditioning after cold storage improves postischemic graft function in isolated porcine kidneys. Transpl Int 23(5):538–542. doi:10.1111/j.1432-2277.2009.01014.x

    Article  PubMed  Google Scholar 

  80. Sato E, Hachisuka T, Yokoyama I, Ohbayashi M, Asai J, Takagi H (1995) Effectiveness of Carolina rinse solution after cold ischemic storage of rat livers: biochemical and histological analysis using perfusion model. Eur Surg Res 27(1):49–56

    Article  CAS  PubMed  Google Scholar 

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Bruns, H., Schemmer, P. Machine perfusion in solid organ transplantation: where is the benefit?. Langenbecks Arch Surg 399, 421–427 (2014). https://doi.org/10.1007/s00423-014-1161-2

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