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Expert Opin Investig Drugs. 2019 Jul;28(7):643-657. doi: 10.1080/13543784.2019.1628217. Epub 2019 Jun 11.

Preventing acute kidney injury during transplantation: the application of novel oxygen carriers.

Thuillier R1,2,3,4, Delpy E5, Matillon X1,6,7,8, Kaminski J1,3, Kasil A1,3, Soussi D1,3,4, Danion J1,3,9, Sauvageon Y1,3,4, Rod X1, Donatini G1,9, Barrou B1,10, Badet L1,6,7,8, Zal F5, Hauet T1,2,3,4,6,11.

Author information

1
a Inserm U1082 , Inserm, Poitiers , France.
2
b Fédération Hospitalo-Universitaire SUPORT , CHU Poitiers, Poitiers , France.
3
c Faculté de Médecine et de Pharmacie , Université de Poitiers , Poitiers , France.
4
d Service de Biochimie , CHU Poitiers , Poitiers , France.
5
e HEMARINA S.A., Aéropole centre, Biotechnopôle , Morlaix , France.
6
f Modélisations Précliniques Innovation Chirurgicale et Technologique , Infrastructures en Biologie et Santé Animale, Génétique, Expérimentations et Systèmes Innovants, Département Génétique Animale , INRA Le Magneraud,Surgères , France.
7
g Service d'urologie et de chirurgie de la transplantation , Hospices Civiles de Lyon , Lyon , France.
8
h Faculté de Médecine Lyon Est , Université Claude Bernard Lyon 1 , Villeurbanne , France.
9
i Service de Chirurgie viscérale et endocrinienne , CHU Poitiers , Poitiers , France.
10
j Service de Transplantation Rénale, Département d'Urologie et de Transplantation , Groupe Hospitalier Pitié Salpétrière , Paris , France.
11
k Consortium for Organ Preservation in Europe, Nuffield Department of Surgical Sciences , Oxford Transplant Centre, Churchill Hospital , Oxford , United Kingdom.

Abstract

INTRODUCTION:

Delayed graft function (DGF) has a significant impact on kidney transplantation outcome. One of the underlying pivotal mechanisms is organ preservation and associated hypothermia and biochemical alteration.

AREAS COVERED:

This paper focuses on organ preservation and its clinical consequences and describes 1. A comprehensive presentation of the pathophysiological mechanism involved in delayed graft function development; 2. The impact on endothelial cells and microvasculature integrity and the consequences on transplanted organ outcome; 3. The reassessment of dynamic organ preservation motivated by the growing use of extended criteria donors and the interest in the potential of normothermia; 4. The role of oxygenation during dynamic preservation; and 5. Novel oxygen carriers and their proof of concept in transplantation, among which M101 (HEMO2life®) is currently the most extensively investigated.

EXPERT OPINION:

Metabolic disturbances and imbalance of oxygen supply during preservation highlight the importance of providing oxygen. Normothermia, permitted by recent advances in machine perfusion technology, appears to be the leading edge of preservation technology. Several oxygen transporters are compatible with normothermia; however, only M101 also demonstrates compatibility with standard hypothermic preservation.

KEYWORDS:

Oxygen carrier; ischemia reperfusion; machine perfusion; organ preservation; transplantation

PMID:
31165652
DOI:
10.1080/13543784.2019.1628217
[Indexed for MEDLINE]

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