{"id":3226,"date":"2021-10-17T12:28:30","date_gmt":"2021-10-17T04:28:30","guid":{"rendered":"https:\/\/transnovo.com\/news\/lifeport%e6%9c%ba%e6%a2%b0%e7%81%8c%e6%b3%a8%e5%af%b9%e5%b0%b8%e4%bd%93%e4%be%9b%e8%82%be%e4%bf%9d%e5%ad%98%e7%9a%84%e4%b8%b4%e5%ba%8a%e8%8e%b7%e7%9b%8a\/"},"modified":"2021-10-17T12:28:30","modified_gmt":"2021-10-17T04:28:30","slug":"lifeport%e6%9c%ba%e6%a2%b0%e7%81%8c%e6%b3%a8%e5%af%b9%e5%b0%b8%e4%bd%93%e4%be%9b%e8%82%be%e4%bf%9d%e5%ad%98%e7%9a%84%e4%b8%b4%e5%ba%8a%e8%8e%b7%e7%9b%8a","status":"publish","type":"post","link":"https:\/\/transnovo.com\/en\/news\/lifeport%e6%9c%ba%e6%a2%b0%e7%81%8c%e6%b3%a8%e5%af%b9%e5%b0%b8%e4%bd%93%e4%be%9b%e8%82%be%e4%bf%9d%e5%ad%98%e7%9a%84%e4%b8%b4%e5%ba%8a%e8%8e%b7%e7%9b%8a\/","title":{"rendered":"Clinical Benefit of LifePort Mechanical Perfusion for Cadaveric Donor Kidney Preservation"},"content":{"rendered":"
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Click on the blue letters -<\/span> FOLLOW US<\/strong><\/p>\n


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Preface<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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Kidney transplantation has become the most effective treatment for end-stage renal failure. However, at present, there is a serious shortage of organ sources in China, and voluntary donation of kidney donor after the death of citizens has become the main source of kidney transplant donors. At present, there are two main preservation methods for donor kidneys: traditional static cryopreservation (SCS) and mechanical perfusion (MP) cryopreservation of renal transporter represented by LifePort. In the former, IRI still occurs in the donor kidney during the preservation process, resulting in a significant increase in the incidence of delayed recovery of grafted renal function (DGF), among others.LifePort is the most widely used machine perfusion instrument, and the results of a large number of experiments have shown that LifePort can reduce the incidence of donor kidney DGF and improve the survival rate of the recipient and transplanted kidney.<\/span><\/strong>In addition, it is portable, easy to operate and fully automated, which can play an important role in kidney transplantation1<\/sup>.<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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LifePort Improves Ischemia-Reperfusion Injury (IRI) and Reduces DGF Incidence in the Donor Kidney<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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IRI is very common in donor kidney transplantation and is a major obstacle to short and long term survival of the graft. Tissue energy depletion during ischemia, acidosis, and the production of large amounts of inflammatory factors and oxygen free radicals during reperfusion may lead to organ dysfunction, thus increasing the incidence of DGF in transplanted kidneys, or even non-function.LifePort is mainly used to perfuse the donor kidney with an effective cryoperfusion solution through continuous mechanical operation, which on one hand provides nutrients for the kidney, and on the other hand transports metabolites produced during cryopreservation from the kidney to the donor. On the one hand, it provides nutrients for the kidney; on the other hand, it transports the metabolites produced by the kidney during cryopreservation.It maintains and repairs the function of the donor kidney to a certain extent, improves the quality of the donor kidney, and thus significantly reduces the incidence of DGF in the transplanted kidney.lower (one's head)<\/span>1<\/sup>.<\/span><\/strong><\/p>\n


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A Cochrane systematic evaluation of the MP versus SCS preservation modalities in cadaveric donor kidney transplantation included a total of 2,266 cadaveric donor kidney transplant patients in 16 RCTs.HMP significantly reduces DGF risk in all patients<\/span><\/strong>(RR 0.77; 95%CI 0.67-0.90; P = 0.0006); significantly reduced DGF risk in kidneys from cardiac death organ donation (DCD) donors (7 studies, 772 subjects: RR 0.75; 95%CI 0.64-0.87; P = 0.0002; high-certainty evidence) and significantly reduced brain death DGF risk in organ donor (DBD) donor kidneys (4 studies, 971 subjects: RR 0.78, 95%CI 0.65-0.93; P = 0.006; high-certainty evidence). A subgroup analysis of 5 modern RCTs with 1355 patients receiving LifePort mechanical perfusion showed a significant reduction in the risk of postoperative DGF with the LifePort mechanical perfusion preservation modality compared with the SCS preservation modality (RR 0.77, 95%CI 0.66-0.91; P = 0.002; high-definiteness evidence, Figure 1)2<\/sup>.<\/p>\n


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Figure 1.Comparison of the risk of DGF between LifePort mechanical perfusion and SCS preservation modalities<\/strong><\/span><\/p>\n<\/section>\n

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LifePort Assesses Preoperative Kidney Quality and Transplant Prognosis<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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LifePort can assess preoperative kidney donor quality by relevant parameters. Yuan Xiaopeng et al. through the use of LifePort perfusion preservation of 20 cases of DCD donor analysis study shows that mechanical perfusion resistance coefficient per minute 0.5mmHg\/mL donor kidneys can also be used for transplantation, but need to carry out a pathology analysis of the donor kidneys and make a comprehensive judgment based on the results. Many foreign scholars, such as Guarrera, have also conducted relevant studies and reached similar conclusions.Evaluation of donor kidney function by means of parameters related to mechanical perfusion instrumentation differs from puncture biopsy in that it is a noninvasive procedure that has value in the use ofyour (honorific)<\/span>1<\/sup>.<\/span><\/strong><\/p>\n


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LifePort resistance index can be used as an index to effectively assess the degree of perfusion of the donor kidney, and has important reference value for determining whether DGF occurs in kidney transplant recipients after surgery. Xiang and Li et al. analyzed the occurrence of postoperative DGF in 340 renal transplant recipients using different methods of donor kidney preservation, of which 286 cases were mechanically perfused with LifePort, and the resistance index ranged from 0.17 to 0.49 mmHg-mL.-1<\/sup>-min-1<\/sup>The postoperative DGF incidence rate was 11.2%; 54 cases of donor kidneys were preserved by SCS, and the postoperative DGF incidence rate was 24.1%, and the difference of DGF incidence rate between the two groups was statistically significant (P < 0.05), the results of this study suggest that LifePort mechanical perfusion can reduce the incidence rate of DGF in addition to the LifePort Resistance Index, which can be an effective assessment of the degree of donor kidney The results of this study suggest that LifePort mechanical perfusion can reduce the incidence of DGF, and LifePort resistance index can effectively assess the degree of perfusion of the donor kidney, which is an important reference value for determining whether DGF occurs in renal transplant recipients after surgery3<\/sup>.<\/p>\n


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In addition, biomarkers in LifePort perfusate combined with perfusion parameters (terminal resistance) may improve the ability to predict DGF. In a study that included 43 cadaveric donor kidneys perfused with LifePort application, multifactorial logistic regression analysis showed that terminal resistance (OR = 1.879, 95%CI 1.145-3.56) and the perfusate marker glutathione S-transferase (GST) (OR = 1.62, 95%CI 1.23-2.46) were independent risk factors for DGF.GST combined with terminal resistance significantly improved the ability to predict DGF compared with terminal resistance alone (P = 0.023)4<\/sup>.<\/p>\n


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Figure 2. efficacy of LifePort perfusate biomarkers to improve perfusion parameters to predict DGF<\/strong><\/span><\/p>\n<\/section>\n

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LifePort expands the source and utilization of donor kidneys and prolongs their preservation.<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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LifePort perfusion preservation can not only provide nutrients to maintain the cellular metabolism of the donor kidney and reduce ischemia-reperfusion injury, but also objectively assess the quality of the donor kidney during the preservation period, which provides a theoretical basis and guarantee for the application of marginal donor kidneys for transplantation.Burdick et al. analyzed the clinical data of 60,827 cases of marginal donor kidneys for renal transplantation at Johns Hopkins Hospital in the U.S.A., and the results showed that The proportion of SCS group needing dialysis after surgery was 2.33 times higher than that of MP group, and the difference was statistically significant (P < 0.05) 1<\/sup>.<\/p>\n


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In addition.LifePort perfusion extends donor kidney preservation time<\/span><\/strong>The report of foreign countries confirmed that the preservation time of LifePort perfusion preservation donor kidney was extended from 24h to 41h. Overseas reports have confirmed that the preservation time of LifePort perfusion preservation of donor kidneys has been extended from the original maximum preservation time of 24 h to 41 h. By prolonging the preservation time of donor kidneys, DCD organ donation can be changed from an emergency surgery to a limited duration surgery or even an elective surgery, so the surgeons will have enough time to select more suitable recipients and make sufficient preoperative preparations to ensure the recipients' postoperative prognosis.1<\/sup>.<\/p>\n


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Summary<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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     LifePort can expand the source of donor kidneys and their utilization by mechanical perfusion, improve IRI, reduce the incidence of DGF, prolong the preservation time of donor kidneys, and evaluate the quality of preoperative donor kidneys and graft prognosis. In addition, it is portable, easy to operate, and fully automated, which has high application value in kidney transplantation.<\/p>\n


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References<\/span><\/p>\n

1. Liu J, Li JJ. Current Research Status of LifePort Preservation of Donor Kidney for Cardiac Death Organ Donor Kidney Transplantation. Zhongnan Journal of Medical Science, 2016, 44(2):228-231.<\/span><\/p>\n

2. Tingle SJ,et al. Machine perfusion preservation versus static cold storage for deceased donor kidney transplantation.Cochrane Database Syst Rev. 2019 Mar 15;3(3):CD011671.<\/span><\/p>\n

3. YE Qifa, et al. Progress of LifePort resistance index in predicting delayed recovery of grafted kidney function after renal transplantation. Chinese Journal of Transplantation, 2017, 11(3):188-191.<\/span><\/p>\n

4. Ding, Chenguang, et al. Correlation analysis of biomarkers in LifePort perfusate with delayed recovery of graft kidney function after cadaveric donor kidney transplantation. Electronic Journal of Practical Organ Transplantation, 2020(2): 115-119.<\/span><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n


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