Is 2 h of Hypothermic Machine Perfusion for Pancreas Preservation Effective in Improving Graft Reperfusion?

Background. Static cold storage (SCS) remains the standard method for organ preservation. The development of parenchymal edema during prolonged hypothermic machine perfusion (HMP) was a major barrier to the introduction of this technique for the preservation of pancreases. A short period of HMP coul...

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Main Authors: Benoit Mesnard, MD, Christophe Masset, MD, PhD, Etohan Ogbemudia, MD, PhD, Sarah Bruneau, PhD, Mohamed Elzawahry, MD, Stéphanie Le Bas-Bernardet, PhD, David Minault, Jeremy Hervouet, Diego Cantarovich, MD, PhD, Jérôme Rigaud, MD, PhD, Lionel Badet, MD, PhD, Peter Friend, MD, PhD, Rutger Ploeg, MD, PhD, Gilles Blancho, MD, PhD, James Hunter, MD, PhD, Thomas Prudhomme, MD, Julien Branchereau, MD, PhD
Format: Article
Language:English
Published: Wolters Kluwer 2025-08-01
Series:Transplantation Direct
Online Access:http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001834
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author Benoit Mesnard, MD
Christophe Masset, MD, PhD
Etohan Ogbemudia, MD, PhD
Sarah Bruneau, PhD
Mohamed Elzawahry, MD
Stéphanie Le Bas-Bernardet, PhD
David Minault
Jeremy Hervouet
Diego Cantarovich, MD, PhD
Jérôme Rigaud, MD, PhD
Lionel Badet, MD, PhD
Peter Friend, MD, PhD
Rutger Ploeg, MD, PhD
Gilles Blancho, MD, PhD
James Hunter, MD, PhD
Thomas Prudhomme, MD
Julien Branchereau, MD, PhD
author_facet Benoit Mesnard, MD
Christophe Masset, MD, PhD
Etohan Ogbemudia, MD, PhD
Sarah Bruneau, PhD
Mohamed Elzawahry, MD
Stéphanie Le Bas-Bernardet, PhD
David Minault
Jeremy Hervouet
Diego Cantarovich, MD, PhD
Jérôme Rigaud, MD, PhD
Lionel Badet, MD, PhD
Peter Friend, MD, PhD
Rutger Ploeg, MD, PhD
Gilles Blancho, MD, PhD
James Hunter, MD, PhD
Thomas Prudhomme, MD
Julien Branchereau, MD, PhD
author_sort Benoit Mesnard, MD
collection DOAJ
description Background. Static cold storage (SCS) remains the standard method for organ preservation. The development of parenchymal edema during prolonged hypothermic machine perfusion (HMP) was a major barrier to the introduction of this technique for the preservation of pancreases. A short period of HMP could optimize the pancreas for reperfusion while minimizing the side effects related to perfusion. Our objective is to evaluate the impact of short-term HMP on the pancreatic reperfusion. Methods. A preclinical study using a controlled donation after circulatory death porcine model was conducted. After procurement, the pancreases were preserved under hypothermic conditions for 2 h either by SCS (n = 4) or HMP (n = 4). After these 2 h of preservation, the pancreases were reperfused using a normothermic machine perfusion (NMP) for 2 h. During NMP, oxygenation, perfusion parameters, biochemical analyses, a glucose stimulation insulin secretion test, and an evaluation of ischemia/reperfusion injury by photoacoustic tomography were assessed. Results. During NMP, resistance indices were significantly lower in the HMP group compared with the SCS group, even after 2 h of reperfusion. The tissue oxygen partial pressure was higher throughout NMP after HMP preservation. Lactate and amylase levels were equal between the 2 groups. Lipase levels were higher in the HMP group. The glucose stimulation test showed no difference between the 2 groups. Photoacoustic tomography assessment showed no endothelial damage in either group. Conclusions. Our study suggests that a short-term HMP applied to pancreases for 2 h is effective in reducing resistance indexes and improving oxygenation.
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spelling doaj-art-886213785e844fdfb65e83035dde15df2025-08-20T03:36:10ZengWolters KluwerTransplantation Direct2373-87312025-08-01118e183410.1097/TXD.0000000000001834202508000-00002Is 2 h of Hypothermic Machine Perfusion for Pancreas Preservation Effective in Improving Graft Reperfusion?Benoit Mesnard, MD0Christophe Masset, MD, PhD1Etohan Ogbemudia, MD, PhD2Sarah Bruneau, PhD3Mohamed Elzawahry, MD4Stéphanie Le Bas-Bernardet, PhD5David Minault6Jeremy Hervouet7Diego Cantarovich, MD, PhD8Jérôme Rigaud, MD, PhD9Lionel Badet, MD, PhD10Peter Friend, MD, PhD11Rutger Ploeg, MD, PhD12Gilles Blancho, MD, PhD13James Hunter, MD, PhD14Thomas Prudhomme, MD15Julien Branchereau, MD, PhD161 Department of Urology and Transplantation Surgery, Nantes University Hospital, Nantes, France.2 Nantes Université, CHU Nantes1, INSERM, Centre for Research in Transplantation and Translational Immunology, UMR 1064, ITUN5, Nantes, France.3 Nuffield Department of Surgical Science, Oxford, United Kingdom.2 Nantes Université, CHU Nantes1, INSERM, Centre for Research in Transplantation and Translational Immunology, UMR 1064, ITUN5, Nantes, France.3 Nuffield Department of Surgical Science, Oxford, United Kingdom.2 Nantes Université, CHU Nantes1, INSERM, Centre for Research in Transplantation and Translational Immunology, UMR 1064, ITUN5, Nantes, France.2 Nantes Université, CHU Nantes1, INSERM, Centre for Research in Transplantation and Translational Immunology, UMR 1064, ITUN5, Nantes, France.2 Nantes Université, CHU Nantes1, INSERM, Centre for Research in Transplantation and Translational Immunology, UMR 1064, ITUN5, Nantes, France.2 Nantes Université, CHU Nantes1, INSERM, Centre for Research in Transplantation and Translational Immunology, UMR 1064, ITUN5, Nantes, France.1 Department of Urology and Transplantation Surgery, Nantes University Hospital, Nantes, France.4 Department of Urology Surgery and Transplantation, Edouard Herriot Hospital, Lyon, France.3 Nuffield Department of Surgical Science, Oxford, United Kingdom.3 Nuffield Department of Surgical Science, Oxford, United Kingdom.2 Nantes Université, CHU Nantes1, INSERM, Centre for Research in Transplantation and Translational Immunology, UMR 1064, ITUN5, Nantes, France.3 Nuffield Department of Surgical Science, Oxford, United Kingdom.2 Nantes Université, CHU Nantes1, INSERM, Centre for Research in Transplantation and Translational Immunology, UMR 1064, ITUN5, Nantes, France.1 Department of Urology and Transplantation Surgery, Nantes University Hospital, Nantes, France.Background. Static cold storage (SCS) remains the standard method for organ preservation. The development of parenchymal edema during prolonged hypothermic machine perfusion (HMP) was a major barrier to the introduction of this technique for the preservation of pancreases. A short period of HMP could optimize the pancreas for reperfusion while minimizing the side effects related to perfusion. Our objective is to evaluate the impact of short-term HMP on the pancreatic reperfusion. Methods. A preclinical study using a controlled donation after circulatory death porcine model was conducted. After procurement, the pancreases were preserved under hypothermic conditions for 2 h either by SCS (n = 4) or HMP (n = 4). After these 2 h of preservation, the pancreases were reperfused using a normothermic machine perfusion (NMP) for 2 h. During NMP, oxygenation, perfusion parameters, biochemical analyses, a glucose stimulation insulin secretion test, and an evaluation of ischemia/reperfusion injury by photoacoustic tomography were assessed. Results. During NMP, resistance indices were significantly lower in the HMP group compared with the SCS group, even after 2 h of reperfusion. The tissue oxygen partial pressure was higher throughout NMP after HMP preservation. Lactate and amylase levels were equal between the 2 groups. Lipase levels were higher in the HMP group. The glucose stimulation test showed no difference between the 2 groups. Photoacoustic tomography assessment showed no endothelial damage in either group. Conclusions. Our study suggests that a short-term HMP applied to pancreases for 2 h is effective in reducing resistance indexes and improving oxygenation.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001834
spellingShingle Benoit Mesnard, MD
Christophe Masset, MD, PhD
Etohan Ogbemudia, MD, PhD
Sarah Bruneau, PhD
Mohamed Elzawahry, MD
Stéphanie Le Bas-Bernardet, PhD
David Minault
Jeremy Hervouet
Diego Cantarovich, MD, PhD
Jérôme Rigaud, MD, PhD
Lionel Badet, MD, PhD
Peter Friend, MD, PhD
Rutger Ploeg, MD, PhD
Gilles Blancho, MD, PhD
James Hunter, MD, PhD
Thomas Prudhomme, MD
Julien Branchereau, MD, PhD
Is 2 h of Hypothermic Machine Perfusion for Pancreas Preservation Effective in Improving Graft Reperfusion?
Transplantation Direct
title Is 2 h of Hypothermic Machine Perfusion for Pancreas Preservation Effective in Improving Graft Reperfusion?
title_full Is 2 h of Hypothermic Machine Perfusion for Pancreas Preservation Effective in Improving Graft Reperfusion?
title_fullStr Is 2 h of Hypothermic Machine Perfusion for Pancreas Preservation Effective in Improving Graft Reperfusion?
title_full_unstemmed Is 2 h of Hypothermic Machine Perfusion for Pancreas Preservation Effective in Improving Graft Reperfusion?
title_short Is 2 h of Hypothermic Machine Perfusion for Pancreas Preservation Effective in Improving Graft Reperfusion?
title_sort is 2 h of hypothermic machine perfusion for pancreas preservation effective in improving graft reperfusion
url http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001834
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