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Serradilla J, Andrés Moreno AM, Talayero P, Burgos P, Machuca M, Camps Ortega O, Vallejo MT, Rubio Bolívar FJ, Bueno A, Sánchez A, Zambrano C, De la Torre Ramos CA, Rodríguez O, Largo C, Serrano P, Prieto Bozano G, Ramos E, López Santamaría M, Stringa P, Hernández F. Preclinical Study of DCD and Normothermic Perfusion for Visceral Transplantation. Transpl Int 2023; 36:11518. [PMID: 37745640 PMCID: PMC10514355 DOI: 10.3389/ti.2023.11518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/25/2023] [Indexed: 09/26/2023]
Abstract
Considering recent clinical and experimental evidence, expectations for using DCD-derived intestines have increased considerably. However, more knowledge about DCD procedure and long-term results after intestinal transplantation (ITx) is needed. We aimed to describe in detail a DCD procedure for ITx using normothermic regional perfusion (NRP) in a preclinical model. Small bowel was obtained from pigs donors after 1 h of NRP and transplanted to the recipients. Graft Intestinal samples were obtained during the procedure and after transplantation. Ischemia-reperfusion injury (Park-Chiu score), graft rejection and transplanted intestines absorptive function were evaluated. Seven of 8 DCD procedures with NRP and ITx were successful (87.5%), with a good graft reperfusion and an excellent recovery of the recipient. The architecture of grafts was well conserved during NRP. After an initial damage of Park-chiu score of 4, all grafts recovered from ischemia-reperfusion, with no or very subtle alterations 2 days after ITx. Most recipients (71.5%) did not show signs of rejection. Only two cases demonstrated histologic signs of mild rejection 7 days after ITx. Interestingly intestinal grafts showed good absorptive capacity. The study's results support the viability of intestinal grafts from DCD using NRP, contributing more evidence for the use of DCD for ITx.
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Affiliation(s)
- Javier Serradilla
- Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain
- Transplant Research Group, Institute for Health Research IdiPaz, Madrid, Spain
| | - Ane Miren Andrés Moreno
- Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain
- Transplant Research Group, Institute for Health Research IdiPaz, Madrid, Spain
| | - Paloma Talayero
- Department of Immunology, University Hospital 12 de Octubre, Madrid, Spain
| | - Paula Burgos
- Transplant Research Group, Institute for Health Research IdiPaz, Madrid, Spain
- Department of Cardiovascular Surgery, La Paz University Hospital, Madrid, Spain
| | - Mariana Machuca
- Special Pathology Laboratory, Faculty of Veterinary Sciences, National University of La Plata, La Plata, Argentina
| | - Onys Camps Ortega
- Molecular Imaging and Immunohistochemistry Laboratory, Institute for Health Research IdiPaz, Madrid, Spain
| | - María Teresa Vallejo
- Molecular Imaging and Immunohistochemistry Laboratory, Institute for Health Research IdiPaz, Madrid, Spain
| | | | - Alba Bueno
- Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain
- Transplant Research Group, Institute for Health Research IdiPaz, Madrid, Spain
| | - Alba Sánchez
- Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain
- Transplant Research Group, Institute for Health Research IdiPaz, Madrid, Spain
| | - Cristina Zambrano
- Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain
| | - Carlos Andrés De la Torre Ramos
- Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain
- Transplant Research Group, Institute for Health Research IdiPaz, Madrid, Spain
| | - Olaia Rodríguez
- Department of Biochemistry, La Paz University Hospital, IdiPaz, Madrid, Spain
| | - Carlota Largo
- Transplant Research Group, Institute for Health Research IdiPaz, Madrid, Spain
- Department of Experimental Surgery, La Paz University Hospital, Madrid, Spain
| | - Pilar Serrano
- Intestinal Rehabilitation and Transplantation Unit, La Paz University Hospital, Madrid, Spain
| | - Gerardo Prieto Bozano
- Intestinal Rehabilitation and Transplantation Unit, La Paz University Hospital, Madrid, Spain
| | - Esther Ramos
- Transplant Research Group, Institute for Health Research IdiPaz, Madrid, Spain
- Intestinal Rehabilitation and Transplantation Unit, La Paz University Hospital, Madrid, Spain
| | - Manuel López Santamaría
- Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain
- Transplant Research Group, Institute for Health Research IdiPaz, Madrid, Spain
| | - Pablo Stringa
- Transplant Research Group, Institute for Health Research IdiPaz, Madrid, Spain
- Institute for Immunological and Pathophysiological Studies (IIFP), National University of La Plata, National Council of Scientific and Technical Research (CONICET), La Plata, Argentina
| | - Francisco Hernández
- Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain
- Transplant Research Group, Institute for Health Research IdiPaz, Madrid, Spain
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