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Organ-specific metabolic profiles of the liver and kidney during brain death and afterwards during normothermic machine perfusion of the kidney

van Erp, A. C., Qi, H., Jespersen, N. R., Hjortbak, M. V., Ottens, P. J., Wiersema-Buist, J., Nørregaard, R., Pedersen, M., Laustsen, C., Leuvenink, H. G. D. & Jespersen, B., 15-Jun-2020, In : American Journal of Transplantation. 12 p.

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We investigated metabolic changes during brain death (BD) using hyperpolarized MR spectroscopy and ex-vivo graft glucose metabolism during normothermic isolated perfused kidney (IPK) machine perfusion. BD was induced in mechanically-ventilated rats by inflation of an epidurally-placed catheter; sham-operated rats served as controls. Hyperpolarized [1-13 C]pyruvate MR spectroscopy was performed to quantify pyruvate metabolism in the liver and kidneys at three timepoints during BD, preceded by injecting hyperpolarized[1-13 C]pyruvate. Following BD, glucose oxidation was measured using tritium-labelled glucose (D-6-3H-glucose) during IPK reperfusion. qPCR and biochemistry were performed on tissue/plasma. Immediately following BD-induction, lactate increased in both organs (liver: eµd 0.21, 95%CI [-0.27, -0.15]; kidney: eµd 0.26, 95%CI [-0.40, -0.12]. After 4 hours of BD, alanine production decreased in the kidney (eµd 0.14, 95%CI [0.03, 0.25], P < .05). Hepatic lactate and alanine profiles were significantly different throughout the experiment between groups (P < .01). During IPK perfusion, renal glucose oxidation was reduced following BD vs sham animals (eµd 0.012, 95%CI [0.004, 0.03, P < .001). No differences in enzyme activities were found. Renal gene expression of lactate-transporter MCT4 increased following BD (P < .01). Concluding, metabolic processes during BD can be visualized in-vivo using hyperpolarized MRI and with glucose oxidation during ex-vivo renal machine perfusion. These techniques can detect differences in the metabolic profiles of the liver and kidney following BD.

Original languageEnglish
Number of pages12
JournalAmerican Journal of Transplantation
Early online date13-Apr-2020
Publication statusPublished - 15-Jun-2020

    Keywords

  • animal models, basic (laboratory) research, science, donors and donation, donation after brain death (DBD), graft survival, kidney (allograft) function, dysfunction, kidney transplantation, nephrology, liver allograft function, liver transplantation, hepatology, organ procurement and allocation, translational research, KETONE-BODY RATIO, MAGNETIC-RESONANCE, HYPERPOLARIZED C-13, RENAL VIABILITY, REDOX STATE, DONOR, GLUCOSE, GRAFT, GLUCONEOGENESIS, TRANSPLANTATION

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