TY - JOUR
T1 - Magnetic resonance imaging as a non-invasive adjunct to conventional assessment of functional differences between kidneys in vivo and during ex vivo normothermic machine perfusion
AU - Hamelink, Tim L
AU - Ogurlu, Baran
AU - Pamplona, Carolina C
AU - Castelein, Johannes
AU - Bennedsgaard, Sigrid S
AU - Qi, Haiyun
AU - Weiss, Thomas
AU - Lantinga, Veerle A
AU - Pool, Merel B F
AU - Laustsen, Christoffer
AU - Jespersen, Bente
AU - Leuvenink, Henri G D
AU - Ringgaard, Steffen
AU - Borra, Ronald J H
AU - Keller, Anna K
AU - Moers, Cyril
N1 - Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.
PY - 2024/10
Y1 - 2024/10
N2 - INTRODUCTION: Normothermic machine perfusion (NMP) is increasingly considered for pre-transplant kidney quality assessment. However, fundamental questions about differences between in vivo and ex vivo renal function, as well as the impact of ischemic injury on ex vivo physiology, remain unanswered. This study utilized magnetic resonance imaging (MRI), alongside conventional parameters to explore differences between in vivo and ex vivo renal function and the impact of warm ischemia on a kidney's behavior ex vivo.METHODS: Renal MRI scans and samples were obtained from living pigs (n=30) in vivo. Next, kidney pairs were procured and exposed to minimal, or 75 min of warm ischemia, followed by 6 hours of hypothermic machine perfusion. Both kidneys simultaneously underwent 6-hour ex vivo perfusion in MRI-compatible NMP circuits to obtain multiparametric MRI data.RESULTS: Ischemically injured ex vivo kidneys showed a significantly altered regional blood flow distribution compared to in vivo and to minimally damaged organs. Both ex vivo groups showed diffusion restriction relative to in vivo.CONCLUSION: Our findings underscore the differences between in vivo and ex vivo MRI-based renal characteristics. Therefore, when assessing organ viability during NMP, it should be considered to incorporate parameters beyond the conventional functional markers that are common in vivo.
AB - INTRODUCTION: Normothermic machine perfusion (NMP) is increasingly considered for pre-transplant kidney quality assessment. However, fundamental questions about differences between in vivo and ex vivo renal function, as well as the impact of ischemic injury on ex vivo physiology, remain unanswered. This study utilized magnetic resonance imaging (MRI), alongside conventional parameters to explore differences between in vivo and ex vivo renal function and the impact of warm ischemia on a kidney's behavior ex vivo.METHODS: Renal MRI scans and samples were obtained from living pigs (n=30) in vivo. Next, kidney pairs were procured and exposed to minimal, or 75 min of warm ischemia, followed by 6 hours of hypothermic machine perfusion. Both kidneys simultaneously underwent 6-hour ex vivo perfusion in MRI-compatible NMP circuits to obtain multiparametric MRI data.RESULTS: Ischemically injured ex vivo kidneys showed a significantly altered regional blood flow distribution compared to in vivo and to minimally damaged organs. Both ex vivo groups showed diffusion restriction relative to in vivo.CONCLUSION: Our findings underscore the differences between in vivo and ex vivo MRI-based renal characteristics. Therefore, when assessing organ viability during NMP, it should be considered to incorporate parameters beyond the conventional functional markers that are common in vivo.
U2 - 10.1016/j.ajt.2024.04.001
DO - 10.1016/j.ajt.2024.04.001
M3 - Article
C2 - 38615901
SN - 1600-6135
VL - 24
SP - 1761
EP - 1771
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 10
ER -