{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T09:47:27Z","timestamp":1793699247790,"version":"4.5.1"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,9,25]],"date-time":"2019-09-25T00:00:00Z","timestamp":1569369600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,9,25]],"date-time":"2019-09-25T00:00:00Z","timestamp":1569369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Normothermic machine perfusion (NMP) of kidney grafts is a promising new preservation method to improve graft quality and clinical outcome. Routinely, kidneys are washed out of blood remnants and cooled using organ preservation solutions prior to NMP. Here we assessed the effect of cold preflush compared to direct NMP. After 30\u2009min of warm ischemia, porcine kidneys were either preflushed with cold histidine-tryptophan-ketoglutarate solution (PFNMP group) prior to NMP or directly subjected to NMP (DNMP group) using a blood\/buffer solution. NMP was performed at a perfusion pressure of 75\u2009mmHg for 6\u2009h. Functional parameters were assessed as well as histopathological and biochemical analyses. Renal function as expressed by creatinine clearance, fractional excretion of sodium and total output of urine was inferior in PFNMP. Urine protein and neutrophil gelatinase-associated lipocalin (NGAL) concentrations as markers for kidney damage were significantly higher in the PFNMP group. Additionally, increased osmotic nephropathy was found after PFNMP. This study demonstrated that cold preflush prior to NMP aggravates ischemia reperfusion injury in comparison to direct NMP of warm ischemia-damaged kidney grafts. With increasing use of NMP systems for kidneys and other organs, further research into graft flushing during retrieval is warranted.<\/jats:p>","DOI":"10.1038\/s41598-019-50101-7","type":"journal-article","created":{"date-parts":[[2019,9,25]],"date-time":"2019-09-25T10:03:33Z","timestamp":1569405813000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Cold Preflush of Porcine Kidney Grafts Prior to Normothermic Machine Perfusion Aggravates Ischemia Reperfusion Injury"],"prefix":"10.1038","volume":"9","author":[{"given":"Gregor","family":"Fabry","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedict M.","family":"Doorschodt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Grzanna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9921-4284","authenticated-orcid":false,"given":"Peter","family":"Boor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3829-4433","authenticated-orcid":false,"given":"Aaron","family":"Elliott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Stollenwerk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9 H.","family":"Tolba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Rossaint","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Bleilevens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,9,25]]},"reference":[{"issue":"10","key":"50101_CR1","doi-asserted-by":"publisher","first-page":"4072","DOI":"10.1016\/j.transproceed.2009.09.089","volume":"41","author":"MC Schreinemachers","year":"2009","unstructured":"Schreinemachers, M. C. et al. Comparison of preservation solutions for washout of kidney grafts: an experimental study. Transplant Proc 41(10), 4072\u20139 (2009).","journal-title":"Transplant Proc"},{"issue":"5","key":"50101_CR2","doi-asserted-by":"publisher","first-page":"1246","DOI":"10.1111\/ajt.12179","volume":"13","author":"ML Nicholson","year":"2013","unstructured":"Nicholson, M. L. & Hosgood, S. A. Renal transplantation after ex vivo normothermic perfusion: the first clinical study. Am J Transplant 13(5), 1246\u201352 (2013).","journal-title":"Am J Transplant"},{"issue":"4","key":"50101_CR3","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1111\/ajt.14059","volume":"17","author":"JM Kaths","year":"2017","unstructured":"Kaths, J. M. et al. Continuous Normothermic Ex Vivo Kidney Perfusion Is Superior to Brief Normothermic Perfusion Following Static Cold Storage in Donation After Circulatory Death Pig Kidney Transplantation. 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