American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2024
Red blood cells as oxygen carrier during normothermic machine perfusion of kidney grafts: Friend or foe?
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Arykbaeva Asel S, Lerink Lente J S, Vos Jaël, Engelse Marten A, van Kooten Cees, de Korte Dirk, Lagerberg Johan W M, Klei Thomas R L, Mulder Aat A, Minnee Robert C, Ploeg Rutger J, Kers Jesper, Moers Cyril, Pol Robert A, Alwayn Ian P J, de Vries Dorottya K, Lindeman Jan H N
Аннотация
Renal ex vivo normothermic machine perfusion (NMP) is under development as an assessment tool for high-risk kidney grafts and as a means of achieving more physiologically accurate organ preservation. On-going hemolysis has been reported during NMP, as this technique relies on red blood cells for oxygen delivery. In this study, we confirm the occurrence of progressive hemolysis during 6-hour kidney NMP. NMP-associated erythrostasis in the glomeruli and in peri-glomerular vascular networks points to an interaction between the red blood cells and the graft. Continuous hemolysis resulted in prooxidative changes in the perfusate, which could be quenched by addition of fresh frozen plasma. In a cell-based system, this hemolysis induced redox stress and exhibited toxic effects at high concentrations. These findings highlight the need for a more refined oxygen carrier in the context of renal NMP.