Porcine kidneys were subjected to 22 h of cold ischaemia then reperfused for 6 h on an ex vivo reperfusion circuit. Pairs of kidneys were randomised to either control (n = 5) or reperfusion with a Cytosorb adsorber (n = 5) integrated into the circuit. Tissue, blood and urine samples were taken for the measurement of inflammation and renal function.
Ex-vivo normothermic perfusion strategies are a promising new instrument in organ transplantation and whilst they are designed to be protective, the artificial environment can induce a local inflammatory response. The aim of this study was to determine the effect of incorporating a CytoSorb adsorber into an isolated kidney perfusion system. Porcine kidneys were subjected to 22 h of cold ischaemia then reperfused for 6 h on an ex vivo reperfusion circuit. Pairs of kidneys were randomised to either control (n = 5) or reperfusion with a CytoSorb adsorber (n = 5) integrated into the circuit. Baseline levels of cytokines were similar between groups. Levels of IL-6 and IL-8 in the perfusate significantly increased during reperfusion in the control group but not in the CytoSorb group. Levels of the other cytokines were numerically lower in the CytoSorb group. The mean renal blood flow (RBF) was significantly higher in the CytoSorb group. Perfusate levels of prostaglandin E2 and thromboxane were significantly lower in the CytoSorb group. While no effect of haemoadsorption on creatinine clearance or renal function could be shown in this model, it can reduce the inflammatory response and improve renal blood flow during perfusion