Detection of ATP by "in Line" 31P Magnetic Resonance Spectroscopy During Oxygenated Hypothermic Pulsatile Perfusion of Pigs' Kidneys

Overview

Journal MAGMA

Publisher Springer

Date 2012 May 31

PMID 22644411

Citations 15

Authors

Francois Lazeyras

Leo Buhler

Jean-Paul Vallee

Martin Hergt

Antonio Nastasi

Raphael Ruttimann

Philippe Morel

Jean-Bernard Buchs

Affiliations

Soon will be listed here.

Abstract

Object: To demonstrate that adenosine triphosphate (ATP), which provides a valuable biomarker for kidney viability in the context of donation after cardiac death (DCD) transplantation, can be detected by means of (31)P magnetic resonance spectroscopy (MRS) if kidneys are perfused with oxygenated hypothermic pulsatile perfusion (O(2)+HPP).

Materials And Methods: Porcine kidney perfusion was carried out using a home made, MR-compatible HPP-machine. Consequently, kidney perfusion could be performed continuously during magnetic resonance imaging and magnetic resonance spectroscopy recording. (31)P MR spectroscopy consisted of 3-dimensional chemical shift imaging (CSI), which allowed for the detection of ATP level in line. (31)P CSI was performed at 3 tesla in 44 min with a nominal voxel size of 6.1 cc.

Results: (31)P CSI enabled the detection of renal ATP when pO(2) was equal to 100 kPa. With pO(2) of 20 kPa, only phosphomonoester, inorganic phosphate and nicotinamide adenine dinucleotide could be found. Semi-quantitative analysis showed that ATP level was 1.3 mM in normal kidney perfused with pO(2) of 100 kPa.

Conclusions: This combined technology may constitute a new advance in DCD organ diagnostics prior to transplantation, as it allows direct assessment of ATP concentration, which provides a reliable indicator for organ bioenergetics and viability. In this study, kidneys presenting no warm ischemia were tested in order to establish values in normal organs. The test could be easily integrated into the clinical environment and would not generate any additional delay into the transplantation clinical workflow.

Citing Articles

Impact of Hypothermic Oxygenated Machine Perfusion on Immune Cell Clearance in Liver Transplantation: Enhancing Graft Function and Post-Transplant Outcomes.

Koch D, Schirren M, Jacobi S, Niess H, Renz B, Werner J J Clin Med. 2025; 14(1.

PMID: 39797210 PMC: 11721044. DOI: 10.3390/jcm14010127.

Endothelial Cells and Mitochondria: Two Key Players in Liver Transplantation.

Parente A, Carvalho M, Schlegel A Int J Mol Sci. 2023; 24(12).

PMID: 37373238 PMC: 10298511. DOI: 10.3390/ijms241210091.

Intermittent Surface Oxygenation Results in Similar Mitochondrial Protection and Maintenance of Aerobic Metabolism as Compared to Continuous Oxygenation during Hypothermic Machine Kidney Machine Perfusion.

Darius T, Vergauwen M, Maistriaux L, Evrard R, Schlegel A, Mueller M J Clin Med. 2023; 12(11).

PMID: 37297930 PMC: 10253557. DOI: 10.3390/jcm12113731.

Current Insights into the Metabolome during Hypothermic Kidney Perfusion-A Scoping Review.

Verstraeten L, Den Abt R, Ghesquiere B, Jochmans I J Clin Med. 2023; 12(11).

PMID: 37297808 PMC: 10253488. DOI: 10.3390/jcm12113613.

Subnormothermic Ex Vivo Porcine Kidney Perfusion Improves Energy Metabolism: Analysis Using P Magnetic Resonance Spectroscopic Imaging.

Agius T, Songeon J, Klauser A, Allagnat F, Longchamp G, Ruttimann R Transplant Direct. 2022; 8(10):e1354.

PMID: 36176724 PMC: 9514833. DOI: 10.1097/TXD.0000000000001354.

References

Chin J, Stiller C, Karlik S . Nuclear magnetic resonance assessment of renal perfusion and preservation for transplantation. J Urol. 1986; 136(6):1351-5. DOI: 10.1016/s0022-5347(17)45336-5. View

Buchs J, Buhler L, Morel P . A new disposable perfusion machine, nuclear magnetic resonance compatible, to test the marginal organs and the kidneys from non-heart-beating donors before transplantation. Interact Cardiovasc Thorac Surg. 2007; 6(4):421-4. DOI: 10.1510/icvts.2006.146043. View

Rudich S, Kaplan B, Magee J, Arenas J, Punch J, Kayler L . Renal transplantations performed using non-heart-beating organ donors: going back to the future?. Transplantation. 2002; 74(12):1715-20. DOI: 10.1097/00007890-200212270-00013. View

Allman T, Holland G, Lenkinski R, Charles H . A simple method for processing NMR spectra in which acquisition is delayed: applications to in vivo localized 31P NMR spectra acquired using the DRESS technique. Magn Reson Med. 1988; 7(1):88-94. DOI: 10.1002/mrm.1910070110. View

Changani K, Fuller B, Bell J, Bryant D, Moore D, Taylor-Robinson S . Hepatic nucleotide triphosphate regeneration after hypothermic reperfusion in the pig model: an in vitro P-NMR study. Transplantation. 1996; 62(6):787-93. DOI: 10.1097/00007890-199609270-00016. View

Bretan Jr P, Vigneron D, Hricak H, Price D, Yen T, Luo J . Assessment of in situ renal transplant viability by 31P-MRS: experimental study in canines. Am Surg. 1993; 59(3):182-7. View

Balupuri S, Buckley P, Mohamad M, Chidambaram V, Gerstenkorn C, Sen B . Early results of a non-heartbeating donor (NHBD) programme with machine perfusion. Transpl Int. 2000; 13 Suppl 1:S255-8. DOI: 10.1007/s001470050336. View

Balupuri S, Strong A, Hoernich N, Snowden C, Mohamed M, Manas D . Machine perfusion for kidneys: how to do it at minimal cost. Transpl Int. 2001; 14(2):103-7. DOI: 10.1007/s001470050855. View

Balupuri S, Buckley P, Snowden C, Mustafa M, Sen B, Griffiths P . The trouble with kidneys derived from the non heart-beating donor: a single center 10-year experience. Transplantation. 2001; 69(5):842-6. DOI: 10.1097/00007890-200003150-00029. View

10.

Dutkowski P, de Rougemont O, Clavien P . Machine perfusion for 'marginal' liver grafts. Am J Transplant. 2008; 8(5):917-24. DOI: 10.1111/j.1600-6143.2008.02165.x. View

11.

Southard J, van Gulik T, Ametani M, Vreugdenhil P, Lindell S, Pienaar B . Important components of the UW solution. Transplantation. 1990; 49(2):251-7. DOI: 10.1097/00007890-199002000-00004. View

12.

Kwiatkowski A, Danielewicz R, Kosieradzki M, Polak W, Wszola M, Fesolowicz S . Six-year experience in continuous hypothermic pulsatile perfusion kidney preservation. Transplant Proc. 2001; 33(1-2):913-5. DOI: 10.1016/s0041-1345(00)02267-3. View

13.

Lietzenmayer R, Henze E, Knorpp R, Schwamborn C, Clausen M, Schnur G . Application of P-31 nuclear magnetic resonance spectroscopy to a new experimental kidney perfusion model using cadaveric porcine kidneys from slaughterhouse. Nephron. 1991; 57(3):340-8. DOI: 10.1159/000186285. View

14.

Lindell S, Compagnon P, Mangino M, Southard J . UW solution for hypothermic machine perfusion of warm ischemic kidneys. Transplantation. 2005; 79(10):1358-61. DOI: 10.1097/01.tp.0000159143.45022.f6. View

15.

Booster M, Wijnen R, Vroemen J, van Hooff J, Kootstra G . In situ preservation of kidneys from non-heart-beating donors--a proposal for a standardized protocol. Transplantation. 1993; 56(3):613-7. DOI: 10.1097/00007890-199309000-00022. View

16.

Cettolo V, Piorico C, Francescato M . T(1) measurement of (31)P metabolites at rest and during steady-state dynamic exercise using a clinical nuclear magnetic resonance scanner. Magn Reson Med. 2006; 55(3):498-505. DOI: 10.1002/mrm.20803. View

17.

Pohmann R, von Kienlin M . Accurate phosphorus metabolite images of the human heart by 3D acquisition-weighted CSI. Magn Reson Med. 2001; 45(5):817-26. DOI: 10.1002/mrm.1110. View

18.

Baicu S, Taylor M, Brockbank K . The role of preservation solution on acid-base regulation during machine perfusion of kidneys. Clin Transplant. 2006; 20(1):113-21. DOI: 10.1111/j.1399-0012.2005.00451.x. View

19.

CLUNIE G, Hardie I . Problems of organ preservation. Aust N Z J Surg. 1976; 46(1):13-8. DOI: 10.1111/j.1445-2197.1976.tb03185.x. View

20.

La Manna G, Conte D, Cappuccilli M, Nardo B, DAddio F, Puviani L . An in vivo autotransplant model of renal preservation: cold storage versus machine perfusion in the prevention of ischemia/reperfusion injury. Artif Organs. 2009; 33(7):565-70. DOI: 10.1111/j.1525-1594.2009.00743.x. View