Review
Medicine, General & Internal
Natalia Warmuzinska, Kamil Luczykowski, Barbara Bojko
Summary: The number of patients on kidney transplant waiting lists is increasing, resulting in a gap between organ demand and availability. To address this shortage, medical professionals have started using marginal kidneys from expanded criteria donors (ECD). However, recipients of ECD kidneys tend to have worse outcomes compared to those receiving organs from standard criteria donors (SCD). Therefore, there is a need for representative methods to assess the quality of these transplant grafts. Current evaluation methods are limited and include interpreting laboratory tests, clinical risk scores, visual evaluation of the organ, and in some cases, a biopsy and perfusion parameters. New technologies have emerged in recent years to examine organ function and understand the mechanisms associated with complications. This review summarizes current diagnostic methods and new potential strategies for graft-quality assessment, identification of complications, perfusion control, and prediction of outcomes.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Biochemistry & Molecular Biology
Anna Radajewska, Anna Krzywonos-Zawadzka, Iwona Bil-Lula
Summary: Kidney transplantation is the standard procedure for treating end-stage renal disease, and machine perfusion has been proven to be a better solution for organ preservation and monitoring.
Review
Medicine, General & Internal
Ahmed S. Ghoneima, Richard X. Sousa X. Da Silva, Martina A. Gosteli, Adam D. Barlow, Philipp Kron
Summary: The high demand for organs in kidney transplantation has led to the widespread use of machine perfusion technologies. This study provides a systematic review of the developments in this field over the past 10 years and compares different perfusion techniques. The results show that dynamic preservation strategies, such as hypothermic machine perfusion, have lower rates of delayed graft function and have the potential to improve outcomes in kidney transplantation.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Surgery
Laurence Verstraeten, Ina Jochmans
Summary: This article discusses the use of organ perfusion technology as a tool for assessing organ viability before transplantation, highlighting current issues, potential developments, and the pros and cons of various perfusion methods.
TRANSPLANT INTERNATIONAL
(2022)
Review
Urology & Nephrology
Asel S. Arykbaeva, Dorottya K. de Vries, Jason B. Doppenberg, Marten A. Engelse, Thomas Hankemeier, Amy C. Harms, Leonie G. Wijermars, Alexander F. Schaapherder, Jaap A. Bakker, Rutger J. Ploeg, Ian P. J. Alwayn, Jan H. N. Lindeman
Summary: Normothermic machine perfusion (NMP) is a novel preservation strategy that maintains organs in a metabolically active state, providing superior organ preservation and allowing viability testing before transplantation. However, current perfusion protocols may not fully address the metabolic requirements of marginal donor grafts. Monitoring of metabolic status during NMP is important for optimal outcomes.
KIDNEY INTERNATIONAL
(2021)
Review
Biochemistry & Molecular Biology
Rebecca Panconesi, Mauricio Flores Carvalho, Matteo Mueller, David Meierhofer, Philipp Dutkowski, Paolo Muiesan, Andrea Schlegel
Summary: Assessment and prediction of liver function is crucial due to the increase of donor risk and majority of marginal organs. Traditional tests require prolonged diagnostic time and are difficult to assess, while dynamic organ preservation strategies offer an opportunity to evaluate organs before implantation through analysis of recirculating perfusates, bile, and perfused liver tissue.
Article
Medicine, General & Internal
Sophie Romann, Tristan Wagner, Shadi Katou, Stefan Reuter, Thomas Vogel, Felix Becker, Haluk Morgul, Philipp Houben, Philip Wahl, Andreas Pascher, Sonia Radunz
Summary: The aim of this study was to evaluate hyperspectral imaging (HSI) as a rapid and non-ionizing technique for assessing organ quality and predicting delayed graft function (DGF) in kidney transplantation. The study found that HSI is a reliable method for assessing renal microperfusion and can be used after organ preservation through static cold storage (SCS) and hypothermic machine perfusion (HMP). Additionally, HSI can predict the development of DGF.
Review
Biochemistry & Molecular Biology
Tom Darius, Jay Nath, Michel Mourad
Summary: The use of high-risk renal grafts for transplantation requires optimization of pretransplant preservation and assessment strategies to improve clinical outcomes and decrease organ discard rate. Oxygenation during hypothermic machine preservation is proposed as a resuscitative measure, providing a critical overview of the fundamentals and suggesting different strategies for clinical implementation.
Article
Cell Biology
Anke Keijbeck, Anniek Raaijmaakers, Lisa Hillen, Marielle Gelens, Sander van Kuijk, Jack P. M. Cleutjens, Carine Peutz-Kootstra, Maarten Christiaans
Summary: In this study, the feasibility of visually assessing renal fibrosis on a continuous scale in renal transplant biopsies was investigated. The study found that there was equivalent interobserver agreement between the assessment in categories (Banff) and the assessment as a percentage of the affected area of the cortex (%ci). Both methods were also associated with morphometric analysis. Additionally, fibrosis was found to be correlated with donor age and estimated glomerular filtration rate (eGFR) at 1 and 5 years post-transplant.
Article
Medicine, General & Internal
Andrzej Konieczny, Jakub Stojanowski, Klaudia Rydzynska, Mariusz Kusztal, Magdalena Krajewska
Summary: In this study, predictive models for DGF were developed using RF and MLP, achieving an accuracy of 84.38% and an AUC of 0.84 with common input parameters. By incorporating additional variables like donor age, gender, KDPI, EPTS, and KDRI, the accuracy of the models improved, showing the potential of machine learning in assessing DGF risk in kidney transplant recipients.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Surgery
Rianne Schutter, Veerle A. Lantinga, Tim L. Hamelink, Merel B. F. Pool, Otis C. van Varsseveld, Jan Hendrik Potze, Jan-Luuk Hillebrands, Marius C. van den Heuvel, Rudi A. J. O. Dierckx, Henri G. D. Leuvenink, Cyril Moers, Ronald J. H. Borra
Summary: The study aimed to characterize the regional distribution of perfusate flow during ex vivo normothermic machine perfusion (NMP) using magnetic resonance imaging (MRI), in order to understand how kidney assessment protocols should be designed. Results showed that at the start of NMP, all kidneys were mainly centrally perfused, and it took time for the outer cortex to reach physiological dominant perfusion state. Early functional NMP quality assessment markers may not reflect actual physiology accurately and should be interpreted with caution.
TRANSPLANT INTERNATIONAL
(2021)
Article
Immunology
Annemarie Weissenbacher, Christina Bogensperger, Rupert Oberhuber, Andras Meszaros, Silvia Gasteiger, Hanno UlmkavyaBer, Valeria Berchtold, Felix J. Krendl, Margot Fodor, Franka Messner, Theresa Hautz, Giorgi Otarashvili, Thomas Resch, Christian Margreiter, Manuel Maglione, Christian Irsara, Andrea Griesmacher, Marc Raynaud, Robert Breitkopf, Jakob Troppmair, Dietmar Ofner, Benno Cardini, Stefan Schneeberger
Summary: This study found that perfusate parameters during normothermic machine perfusion (NMP) can predict early allograft dysfunction (EAD) after liver transplantation. Aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, alkaline phosphatase, and sodium levels in the perfusate were correlated with EAD. Additionally, the number of perfusate platelets and von Willebrand Factor antigen were also important indicators for EAD occurrence. Lower perfusate pH was associated with a higher risk of EAD.
Article
Urology & Nephrology
Aravind Cherukuri, Khodor I. Abou-Daya, Raad Chowdhury, Rajil B. Mehta, Sundaram Hariharan, Parmjeet Randhawa, David M. Rothstein
Summary: Borderline rejection in renal transplantation is associated with decreased allograft survival. Identifying patients with early borderline rejection at risk for poor outcomes is important for timely intervention.
KIDNEY INTERNATIONAL
(2023)
Article
Physiology
Rosa G. M. Lammerts, Lisanne M. Lagendijk, Gesa Tiller, Wendy A. Dam, Harriet L. Lancaster, Mohamed R. Daha, Marc A. Seelen, Bouke G. Hepkema, Robert A. Pol, Henri G. D. Leuvenink, Grietje Molema, Jacob van den Born, Stefan P. Berger
Summary: Renal endothelial cells play important roles in renal diseases, and a new method of isolating ECs from the perfusate of donor kidneys has been described in this study, demonstrating potential diagnostic value in HLA antibody-specific cross-matching tests and further applications in renal endothelial research.
AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY
(2021)
Article
Medicine, General & Internal
Mathieu Kaczmarek, Jean-Michel Halimi, Jean-Baptiste de Freminville, Philippe Gatault, Juliette Gueguen, Nicolas Goin, Helene Longuet, Christelle Barbet, Arnaud Bisson, Benedicte Sautenet, Julien Herbert, Matthias Buchler, Laurent Fauchier
Summary: A new universal risk score for bleeding after percutaneous biopsy in kidney transplant recipients was developed based on a study of 28,034 patients in France. The score takes into account anemia, female gender, heart failure, and acute kidney failure, and can guide the decision-making process for kidney biopsy procedures.
JOURNAL OF CLINICAL MEDICINE
(2023)
Letter
Gastroenterology & Hepatology
Lucas Wauters, Mathias Clarysse, Ina Jochmans, Diethard Monbaliu, Laurens J. Ceulemans, Astrid Verbiest, Marc Miserez, Nathalie Lauwers, Wendy Nys, Nelle Pauwels, Martin Hiele, Jacques Pirenne, Tim Vanuytsel
Article
Gastroenterology & Hepatology
Janina Eden, Richard Xavier Sousa Da Silva, Miriam Cortes-Cerisuelo, Kristopher Croome, Riccardo De Carlis, Amelia J. Hessheimer, Xavier Muller, Femke de Goeij, Vanessa Banz, Giulia Magini, Philippe Compagnon, Andreas Elmer, Andrea Lauterio, Rebecca Panconesi, Jeannette Widmer, Daniele Dondossola, Paolo Muiesan, Diethard Monbaliu, Marieke de Rosner van van Rosmalen, Olivier Detry, Constantino Fondevila, Ina Jochmans, Jacques Pirenne, Franz Immer, Gabriel C. Oniscu, Jeroen de Jonge, Mickael Lesurtel, Luciano G. De Carlis, C. Burcin Taner, Nigel Heaton, Andrea Schlegel, Philipp Dutkowski
Summary: Liver graft utilization rates and discard rates vary across countries, with machine perfusion strategies contributing to better DCD utilization rates. Risk factors and use of various machine perfusion techniques vary between countries, but this does not significantly impact 5-year graft survival rates. Overall, countries with routine use of machine perfusion strategies have higher DCD utilization rates without compromised outcomes.
JOURNAL OF HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Andrea Schlegel, Matteo Mueller, Xavier Mueller, Janina Eden, Rebecca Panconesi, Stefanie von Felten, Klaus Steigmiller, Richard X. Sousa Da Silva, Olivier de Rougemont, Jean-Yves Mabrut, Mickael Lesurtel, Miriam Cortes Cerisuelo, Nigel D. Heaton, Marc Antoine Allard, Rene Adam, Diethard Monbaliu, Ina Jochmans, Martijn P. D. Haring, Robert J. Porte, Alessandro Parente, Paolo Muiesan, Philipp Kron, Magdy Attia, Dagmar Kollmann, Gabriela Berlakovich, Xavier Rogiers, Karin Petterson, Anne L. Kranich, Stefanie Amberg, Beat Mullhaupt, Pierre-Alain Clavien, Philipp Dutkowski
Summary: Hypothermic oxygenated perfusion (HOPE) after cold storage of donated livers reduces the incidence of complications and graft failure in liver transplantation.
JOURNAL OF HEPATOLOGY
(2023)
Article
Surgery
Benedict T. K. Vanlerberghe, Hannah van Malenstein, Mauricio Sainz-Bariga, Ina Jochmans, David Cassiman, Diethard Monbaliu, Schalk van der Merwe, Jacques Pirenne, Frederik Nevens, Jef Verbeek
Summary: Recently, the concept of metabolic dysfunction-associated fatty liver disease (MAFLD) has been proposed to replace non-alcoholic fatty liver disease (NAFLD). This study assessed the prevalence of MAFLD in ALD patients undergoing liver transplantation (LTx) and its impact on post-transplant outcomes.
CLINICAL TRANSPLANTATION
(2023)
Article
Virology
Benedict Vanlerberghe, Casper Vrij, Kris Bogaerts, Pieter Vermeersch, Katrien Lagrou, Geert Molenberghs, Filip Rega, Laurens J. Ceulemans, Dirk van Raemdonck, Ina Jochmans, Diethard Monbaliu, Jacques Pirenne, Tim Vanuytsel, Pieter Gillard, Helene Schoemans, Johan Van Cleemput, Dirk Kuypers, Robin Vos, Frederik Nevens, Jef Verbeek
Summary: This observational study investigated the effectiveness of SARS-CoV-2 vaccines and breakthrough infections in transplant recipients. It found significant variations in antibody response rates and rates of severe infections among different transplant types, which were modulated by specific risk factors. These findings highlight the importance of tailored COVID-19 prevention measures for transplant recipients.
JOURNAL OF MEDICAL VIROLOGY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Laurence Verhaeghe, Andries Van Holsbeeck, Lawrence Bonne, Eveline Claus, Jesse Marrannes, Ruben Vandenbulcke, Ina Jochmans, Jacques Pirenne, Geert Maleux
Summary: This study analyzed the safety, technical success, and clinical outcome of percutaneous intranodal ethiodized oil-based lymphangiography (L-LAG) for the management of refractory pelvic lymphoceles or chylous ascites. The study found that L-LAG using high doses of ethiodized oil is a minimally invasive, safe, and effective treatment, although multiple sessions may be needed to achieve significant clinical results.
DIAGNOSTIC AND INTERVENTIONAL IMAGING
(2023)
Review
Medicine, General & Internal
Laurence Verstraeten, Rutger Den Abt, Bart Ghesquiere, Ina Jochmans
Summary: This scoping review summarizes the current knowledge on kidney metabolism during hypothermic perfusion preservation. A total of 52 papers were included in this review, which covered studies on dogs, rabbits, pigs, and humans published between 1970 and 2023. The studies reported the use of different perfusates, oxygenation levels, kidney injury levels, and devices, and examined the perfusate and tissue metabolites. The findings suggest that kidneys remain metabolically active during hypothermic perfusion, regardless of the perfusion settings. However, the understanding of kidney metabolism during hypothermic perfusion is still incomplete and influenced by various factors.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Nicolas Meurisse, Markoen Mertens, Steffen Fieuws, Nicholas Gilbo, Ina Jochmans, Jacques Pirenne, Diethard Monbaliu
Summary: A study on liver transplant found that a combined drug approach targeting the donor graft and graft recipient did not reduce ischemia-reperfusion injury. This suggests that a clinically effective combined drug approach may need to include an upstream strategy targeting the donor graft.
Article
Surgery
John F. Mulvey, Sadr ul Shaheed, Philip D. Charles, Corinna Snashall, Maria Letizia Lo Faro, Christopher W. Sutton, Ina Jochmans, Jacques Pirenne, Cees van Kooten, Henri G. D. Leuvenink, Maria Kaisar, Rutger J. Ploeg
Summary: Perfusate profiling by mass spectrometry provided biologically meaningful proteomic changes that partially explained the clinical observations of the COMPARE trial.
Article
Biochemistry & Molecular Biology
Joris Blondeel, Nicholas Gilbo, Veerle Heedfeld, Tine Wylin, Louis Libbrecht, Ina Jochmans, Jacques Pirenne, Hannelie Korf, Diethard Monbaliu
Summary: During normothermic machine perfusion (NMP), livers procured after warm ischemia (WI) exhibit a distinct innate immune response compared to directly procured (DP) livers. The cytokine profile in WI livers shifts towards an anti-inflammatory phenotype during NMP and whole blood (WB) reperfusion, while pro-apoptotic signaling is stronger during NMP. WB reperfusion results in a blunted cytokine release in livers, suggesting a reconditioning effect of NMP, regardless of ischemic damage.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Multidisciplinary Sciences
Fenna E. M. van de Leemkolk, M. Letizia Lo Faro, Sadr F. Shaheed, John Mulvey, Volkert A. L. Huurman, Ian P. J. Alwayn, Hein Putter, Ina Jochmans, Jan H. N. Lindeman, Rutger Ploeg
Summary: This study aimed to validate flavin mononucleotide (FMN) as a biomarker for kidney quality during machine perfusion, but the results showed that FMN was not associated with post-transplant kidney function.
Meeting Abstract
Immunology
Suria Rowell, Emilio Canovai, Thomas Douchy, Tim Vanuytsel, Diethard Monbaliu, Ina Jochmans, Laurens Ceulemans, Jacques Pirenne, Marc Gewillig
Meeting Abstract
Cardiac & Cardiovascular Systems
K. Vandendriessche, J. Brouckaert, K. Degezelle, L. Ceulemans, I. Jochmans, D. Monbaliu, S. Rex, B. Meyns, J. Van Cleemput, A. Neyrinck, F. Rega
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2023)
Meeting Abstract
Cardiac & Cardiovascular Systems
K. Vandendriessche, M. Orlitova, A. Vanstapel, W. Coudyzer, S. Verleden, I. Jochmans, D. Monbaliu, L. Ceulemans, D. Van Raemdonck, B. Meyns, F. Rega, A. Neyrinck
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2022)
Meeting Abstract
Cardiac & Cardiovascular Systems
C. Boelhouwer, K. Vandendriessche, D. Van Raemdonck, I. Jochmans, D. Monbaliu, J. Pirenne, J. Gunst, E. De Troy, C. Vandenbriele, K. Degezelle, B. Desschans, K. Denaux, L. Godinas, R. Vos, G. Verleden, F. Rega, A. Neyrinck, L. Ceulemans
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2022)