12 Facts About Machine perfusion

Machine perfusion is a technique used in organ transplantation as a means of preserving the organs which are to be transplanted.

Machine perfusion has various forms and can be categorised according to the temperature of the perfusate: cold and warm.

Machine perfusion has been applied to renal transplantation, liver transplantation and lung transplantation.

Machine perfusion had a near survivor, after 24-hour kidney storage and delayed contralateral nephrectomy, in a dog that developed a late arterial thrombosis in the kidney.

Machine perfusion used diluted plasma or serum as the perfusate and pointed out the necessity for low perfusate pressures to prevent kidney swelling, but admitted that the optimum values for such variables as perfusate temperature, Po2, and flow, remained unknown.

Belzer found that the crucial factor in permitting uncomplicated 72-hour Machine perfusion was cryoprecipitation of the plasma used in the perfusate to reduce the amount of unstable lipo-proteins which otherwise precipitated out of solution and progressively obstructed the kidney's vascular system.

Machine perfusion based his technique on the observation by Keller that the loss of electrolytes from a kidney during storage could be prevented by the use of a storage fluid containing cations in quantities approaching those normally present in cells.

Major simplification to the techniques of hypothermic Machine perfusion storage was made by Johnson and Claes in 1972 with the introduction of an albumin based perfusate.

Machine perfusion compared various perfusate compositions and found that a phosphate buffered perfusate could be used successfully, so eliminating the need for a carbon dioxide supply.

Kastagir analysed urine produced during 24-hour Machine perfusion and found it to be an ultrafiltrate of the perfusate, Scott found a trace of protein in the urine during 24-hour storage, and Pederson found only a trace of protein after 36 hours Machine perfusion storage.

Pegg has shown that rabbit kidneys can resynthesize ATP after a period of Machine perfusion storage following warm injury, but no resynthesis occurred in non warm-injured kidneys.

Machine perfusion had taken biopsies at revascularisation from human kidneys preserved by perfusion or ice storage, and showed by electron microscopy that endothelial disruption only occurred in those kidneys that had been perfused.