Liver repair, regeneration and preservation in experimental work
This experimental programme is looking into translational experimental studies in liver repair, regeneration and preservation protocols during ECMO and their outcome in liver transplantation. It is led by Professor Thomas Minor and his research team at the University Clinic Essen (DE) with collaboration from Groningen. The machines are manufactured by Organ Assist and the perfusion solutions are developed by our partners Aqix and Hemarina.
The objectives of the project are to develop a new cell free solution for ex-vivo normothermic machine liver perfusion and to establish the optimal regeneration conditions for damaged livers by short-term pre-implantation ex-vivo liver perfusion. The work envolves pig liver grafts from DCD donors that are preserved for four hours using static cold storage in UW solution followed by 90 min of pre-implantation resuscitation treatment with oxygenated machine perfusion using colloidal AQIX RS-I solution supplemented with Hemo2Life according to the results obtained in other tasks. The efficacy of the treatment will be evaluated in an isolated porcine liver perfusion model in Bonn; and finally, the optimal protocol will be tested in a proof of concept study in the pig transplant model.
Kidney repair, regeneration and preservation in experimental work
The second experimental programme in our project is investigating translational experimental studies in kidney repair, regeneration and preservation protocols. There are three experimental routes that this work package will undertake - led by Professor Henri Leuvenink from the University Medical Centre of Groningen alongside the teams from Poitiers and Essen, with machines manufactured by Organ Assist, and solutions developed by Aqix and Hemarina.
The objectives are to explore new oxygenated kidney perfusion modalities supporting metabolic function, to refine the biophysical conditions for pre-implantation ex-vivo kidney resuscitation and to evaluate the effects of temperature and the addition of additives during ECMO on the outcomes of kidney transplantation.
Task 1 aims to explore new oxygenated kidney perfusion modalities supporting metabolic function, using a similar step-wise approach as in the liver non-clinical research package. This experiment will look to the role of nutritional support with AQIX RS-I and oxygen delivery with Hemo2Life during ex vivo machine perfusion. With the outcome of the clinical study CSO-K and the results from the first experimental task a regeneration protocol will be tested using porcine kidneys, subjected to extended warm ischemia of 60 minutes, and a prolonged cold ischemia of 20 hrs cold storage; that will be regenerated using a Kidney-Assist Machine (Organ-Assist) for one or two hours using the optimised HMP solution (AQIX RS-I/ Hemo2life). Using a well established swine pre-clinical model for DCD available in Poitiers, the ECOPS device will be used to explore the effects of abdominal perfusion with the AQIX RS-I/Hemo2Life solution designed in WP4.