Transplantation · 2025
Normothermic Ex Vivo Machine Perfusion Mitigates Apoptosis in a Porcine Model of Pancreas Transplantation.
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Parmentier Catherine, Ray Samrat, Kawamura Masataka, Mazilescu Laura I, Nogueira Emmanuel, Hobeika Christian, Calderón-Novoa Francisco, Chu Tunpang, Ganesh Sujani, Arulratnam Bhranavi, Kalimuthu Sangeetha N, Martínez-Arenas Laura, Selzner Markus, Reichman Trevor W
Аннотация
BACKGROUND: Pancreas transplantation is one of the most effective treatment options for individuals diagnosed with complicated diabetes. However, the pancreas has one of the strictest acceptance criteria and the highest discard rate of any organ after retrieval. Normothermic ex vivo perfusion (NEVP) has emerged as a promising strategy to evaluate and potentially improve the quality of pancreatic grafts before transplantation.
METHODS: Using a porcine model of pancreas transplantation, we compared 5 h of static cold storage (SCS; n = 4) with 2 h of SCS followed by 3 h of NEVP (n = 4). Parameters such as graft hemodynamics, blood biochemistry, and histopathology were evaluated. The animals were followed up for 3 d after transplantation.
RESULTS: A glucose tolerance test performed on day 3 was comparable between the 2 groups ( P = 0.71). The NEVP group exhibited a significantly lower number of terminal deoxynucleotidyl transferase dUTP nick end labeling-positive cells compared with the SCS group ( P = 0.01). Additionally, plasma and tissue levels of 8-hydroxy-2-deoxyguanosine were significantly lower in the NEVP group on postoperative day 3 compared with the SCS group ( P = 0.01). However, within-group comparisons did not show statistically significant changes over time.
CONCLUSIONS: This study demonstrates that the addition of NEVP significantly reduces apoptosis after reperfusion and may help stabilize oxidative stress levels. These findings suggest that NEVP could be a valuable approach for improving the quality and viability of pancreatic grafts before transplantation, but further research is needed to confirm.
METHODS: Using a porcine model of pancreas transplantation, we compared 5 h of static cold storage (SCS; n = 4) with 2 h of SCS followed by 3 h of NEVP (n = 4). Parameters such as graft hemodynamics, blood biochemistry, and histopathology were evaluated. The animals were followed up for 3 d after transplantation.
RESULTS: A glucose tolerance test performed on day 3 was comparable between the 2 groups ( P = 0.71). The NEVP group exhibited a significantly lower number of terminal deoxynucleotidyl transferase dUTP nick end labeling-positive cells compared with the SCS group ( P = 0.01). Additionally, plasma and tissue levels of 8-hydroxy-2-deoxyguanosine were significantly lower in the NEVP group on postoperative day 3 compared with the SCS group ( P = 0.01). However, within-group comparisons did not show statistically significant changes over time.
CONCLUSIONS: This study demonstrates that the addition of NEVP significantly reduces apoptosis after reperfusion and may help stabilize oxidative stress levels. These findings suggest that NEVP could be a valuable approach for improving the quality and viability of pancreatic grafts before transplantation, but further research is needed to confirm.