Comparison of a New Fully Synthetic Perfusion Solution to Belzer MPS for 24-H Hypothermic Oxygenated Perfusion of Porcine Kidneys: A Feasibility Study.

BACKGROUND

Kidney transplantation remains the only curative therapy for end-stage renal disease, yet organ shortage limits its impact. Static cold storage of kidney, still widely used because of its cost effectiveness, is often associated with ischemia-reperfusion injury and delayed graft function. Hypothermic oxygenated perfusion (HOPE), has emerged as a superior preservation method, reducing ischemia-reperfusion injury and delayed graft function, especially in marginal donor organs. Optimized organ perfusion solutions are needed to unleash the full potential of HOPE. Here, we compared a new, fully synthetic organ preservation solution (Omnisol) against the gold standard (Belzer MPS).

MATERIALS AND

METHODS

HOPE for 24 h was applied to porcine kidney grafts in a head-to-head comparison (n = 5 Omnisol versus n = 5 Belzer MPS). Perfusion parameters and temperature, as well as injury markers (AST, LDH, lactate), and histopathology were assessed.

RESULTS

Perfusion flow was more stable for 24 h in the Omnisol group, with a constant pH (Baseline, BL: 7.37; 24 h: 7.39), in contrast to significantly lower pH in the Belzer MPS group (BL: 7.16; 24 h: 7.23). Injury markers only slightly increased in both groups. Omnisol kidneys showed physiological histological findings (significantly lower vacuolar degeneration and tubular dilatation), in contrast to grafts perfused with Belzer MPS.

CONCLUSIONS

In this exploratory setting, Omnisol was feasible for 24 h HOPE of kidney grafts, and comparisons with Belzer MPS revealed differences in perfusion and histopathological parameters.