Persufflation (or Gaseous Oxygen Perfusion) As a Method of Organ Preservation

Overview

Journal Cryobiology

Publisher Elsevier

Specialty Biology

Date 2012 Feb 4

PMID 22301419

Citations 14

Authors

Thomas M Suszynski

Michael D Rizzari

William E Scott 3rd

Linda A Tempelman

Michael J Taylor

Klearchos K Papas

Affiliations

Soon will be listed here.

Abstract

Improved preservation techniques have the potential to improve transplant outcomes by better maintaining donor organ quality and by making more organs available for allotransplantation. Persufflation, (PSF, gaseous oxygen perfusion) is potentially one such technique that has been studied for over a century in a variety of tissues, but has yet to gain wide acceptance for a number of reasons. A principal barrier is the perception that ex vivo PSF will cause in vivo embolization post-transplant. This review summarizes the extensive published work on heart, liver, kidney, small intestine and pancreas PSF, discusses the differences between anterograde and retrograde PSF, and between PSF and other conventional methods of organ preservation (static cold storage, hypothermic machine perfusion). Prospective implications of PSF within the broader field of organ transplantation, and in the specific application with pancreatic islet isolation and transplant are also discussed. Finally, key issues that need to be addressed before PSF becomes a more widely utilized preservation strategy are summarized and discussed.

Citing Articles

Biostasis: A Roadmap for Research in Preservation and Potential Revival of Humans.

McKenzie A, Wowk B, Arkhipov A, Wrobel B, Cheng N, Kendziorra E Brain Sci. 2024; 14(9).

PMID: 39335436 PMC: 11430499. DOI: 10.3390/brainsci14090942.

Antegrade persufflation of porcine kidneys improves renal function after warm ischemia.

Min C, Galons J, Lynch R, Steyn L, Price N, Weegman B Front Transplant. 2024; 3:1420693.

PMID: 39239359 PMC: 11375613. DOI: 10.3389/frtra.2024.1420693.

Study of Hepatic Vascular Dynamics Based on Symmetrical Pulsating Perfusion.

Liu J, Tian L, Wang S, Luo Z Ann Transplant. 2019; 24:214-222.

PMID: 31000689 PMC: 6486798. DOI: 10.12659/AOT.913008.

Oxygen Perfusion (Persufflation) of Human Pancreata Enhances Insulin Secretion and Attenuates Islet Proinflammatory Signaling.

Kelly A, Smith K, Purvis W, Min C, Weber C, Cooksey A Transplantation. 2018; 103(1):160-167.

PMID: 30095738 PMC: 6371803. DOI: 10.1097/TP.0000000000002400.

Impact of Oxygen on Pancreatic Islet Survival.

Komatsu H, Kandeel F, Mullen Y Pancreas. 2018; 47(5):533-543.

PMID: 29621044 PMC: 5943071. DOI: 10.1097/MPA.0000000000001050.

References

Minor T, Isselhard W . Synthesis of high energy phosphates during cold ischemic rat liver preservation with gaseous oxygen insufflation. Transplantation. 1996; 61(1):20-2. DOI: 10.1097/00007890-199601150-00005. View

Iwanaga Y, Sutherland D, Harmon J, Papas K . Pancreas preservation for pancreas and islet transplantation. Curr Opin Organ Transplant. 2008; 13(4):445-51. PMC: 2858000. DOI: 10.1097/MOT.0b013e328303df04. View

Tolstykh G, Gelineau J, Maier L, Bunegin L . Novel portable hypothermic pulsatile perfusion preservation technology: Improved viability and function of rodent and canine kidneys. Ann Transplant. 2010; 15(3):35-43. View

Totsuka E, Fung U, Hakamada K, Tanaka M, Takahashi K, Nakai M . Analysis of clinical variables of donors and recipients with respect to short-term graft outcome in human liver transplantation. Transplant Proc. 2004; 36(8):2215-8. DOI: 10.1016/j.transproceed.2004.08.052. View

Kuhn-Regnier F, Fischer J, Jeschkeit S . Coronary oxygen persufflation for long-term myocardial protection. Thorac Cardiovasc Surg. 1998; 46 Suppl 2:308-12. DOI: 10.1055/s-2007-1013091. View

GABEL L, Bihler I, DRESEL P . Contractility, metabolism and pharmacological reactions of isolated gas-perfused cat hearts. Circ Res. 1966; 19(5):891-902. DOI: 10.1161/01.res.19.5.891. View

Lauschke H, Kotting M, Akbar S, Minor T . Use of taurine as antioxidant in resuscitating livers from non-heart-beating donors by gaseous oxygen persufflation. J Invest Surg. 2003; 16(1):7-11. View

Minor T, Klauke H, Isselhard W . Improved preservation of the small bowel by luminal gas oxygenation: energetic status during ischemia and functional integrity upon reperfusion. Transplant Proc. 1997; 29(7):2994-6. DOI: 10.1016/s0041-1345(97)00757-4. View

Isselhard W, Witte J, Denecke H, Berger M, Fischer J . [Kidney function following hypothermic aerobic ischemia in situ]. Pflugers Arch. 1972; 332:Suppl 332:R26. View

10.

Scott 3rd W, OBrien T, Ferrer-Fabrega J, Avgoustiniatos E, Weegman B, Anazawa T . Persufflation improves pancreas preservation when compared with the two-layer method. Transplant Proc. 2010; 42(6):2016-9. PMC: 2956134. DOI: 10.1016/j.transproceed.2010.05.092. View

11.

Dionne K, Colton C, Yarmush M . Effect of hypoxia on insulin secretion by isolated rat and canine islets of Langerhans. Diabetes. 1993; 42(1):12-21. DOI: 10.2337/diab.42.1.12. View

12.

Ross H, Escott M . Gaseous oxygen perfusion of the renal vessels as an adjunct in kidney preservation. Transplantation. 1979; 28(5):362-4. DOI: 10.1097/00007890-197911000-00002. View

13.

Laine G, Allen S . Left ventricular myocardial edema. Lymph flow, interstitial fibrosis, and cardiac function. Circ Res. 1991; 68(6):1713-21. DOI: 10.1161/01.res.68.6.1713. View

14.

Piratvisuth T, Tredger J, Hayllar K, Williams R . Contribution of true cold and rewarming ischemia times to factors determining outcome after orthotopic liver transplantation. Liver Transpl Surg. 1995; 1(5):296-301. DOI: 10.1002/lt.500010505. View

15.

Ojo A, Wolfe R, Held P, Port F, Schmouder R . Delayed graft function: risk factors and implications for renal allograft survival. Transplantation. 1997; 63(7):968-74. DOI: 10.1097/00007890-199704150-00011. View

16.

Ryan E, Lakey J, Rajotte R, Korbutt G, Kin T, Imes S . Clinical outcomes and insulin secretion after islet transplantation with the Edmonton protocol. Diabetes. 2001; 50(4):710-9. DOI: 10.2337/diabetes.50.4.710. View

17.

Scott 3rd W, Weegman B, Ferrer-Fabrega J, Stein S, Anazawa T, Kirchner V . Pancreas oxygen persufflation increases ATP levels as shown by nuclear magnetic resonance. Transplant Proc. 2010; 42(6):2011-5. PMC: 2947552. DOI: 10.1016/j.transproceed.2010.05.091. View

18.

Treckmann J, Nagelschmidt M, Minor T, Saner F, Saad S, Paul A . Function and quality of kidneys after cold storage, machine perfusion, or retrograde oxygen persufflation: results from a porcine autotransplantation model. Cryobiology. 2009; 59(1):19-23. DOI: 10.1016/j.cryobiol.2009.03.004. View

19.

Wight J, Chilcott J, Holmes M, Brewer N . The clinical and cost-effectiveness of pulsatile machine perfusion versus cold storage of kidneys for transplantation retrieved from heart-beating and non-heart-beating donors. Health Technol Assess. 2003; 7(25):1-94. DOI: 10.3310/hta7250. View

20.

Gott V, Gonzalez J, ZUHDI M, VARCO R, Lillehei C . Retrograde perfusion of the coronary sinus for direct vision aortic surgery. Surg Gynecol Obstet. 1957; 104(3):319-28. View