Background
Following clinical implementation of hypothermic machine perfusion (HMP) prior to kidney transplantation, ex-vivo normothermic machine perfusion (NMP) has been intensely studied as a promising tool for assessment and reconditioning of kidney function. Additionally, NMP provides an opportunity for ex-vivo pharmacological intervention before transplantation. Ex-vivo pharmacological intervention targeted towards the inflammatory pathways associated with the initiation of acute kidney injury are therefore promising novel therapies in the prevention of ischemia-reperfusion injury.

Aim
The aim of this project is to evaluate the feasibility of different biological-based therapeutic interventions during ex-vivo NMP with the intention to prevent the signalling of different inflammatory pathways during NMP, hopefully leading to a better post-transplant outcome.

Methods
Paired porcine kidneys are exposed to a period of warm ischemia following overnight HMP and subsequent NMP using erythrocyte-based perfusate. During NMP, kidneys are randomized to therapeutic intervention or control. Samples from tissue, perfusate and urine are continuously collected to evaluate the effect(s) of intervention.

Perspectives
Providing a proof of concept of the feasibility and safety of ex-vivo pharmacological intervention during NMP could improve the clinical results of kidney. Follow-up studies will be able to combine ex-vivo treatment with an auto-transplantation model to investigate outcomes of intervention following transplantation.

Collaboration
Department of Renal Medicine, Aarhus University Hospital
Department of Urology, Aarhus University Hospital
Department of Organ Surgery and Transplantation, University Medical Center Groningen

Contact:
Thomas Weiss, Research year student
Department of Renal Medicine
Thowei@clin.au.dk
+45 50720944

Pernille Duedahl, Research year student
Department of Renal Medicine
perdue@post.au.dk
+45 25794406