The effects of oxygenation on ex vivo kidneys undergoing Hypothermic Machine Perfusion

Background Supplemental oxygenation of the standard Hypothermic Machine Perfusion (HMP) circuit has the potential to invoke favourable changes in metabolism, optimising cadaveric organs prior to transplantation. Methods Eight pairs of porcine kidneys underwent 18 hours of either oxygenated (HMP/O2) or aerated (HMP/Air) HMP in a paired DCD model of transplantation. Circulating perfusion fluid was supplemented with the metabolic tracer universally labelled glucose ([U-13C] glucose). Perfusate, end-point renal cortex and medulla samples underwent metabolomic analysis using 1D and 2D NMR experiments in addition to GC-MS. Analysis of 13C labelled metabolic products was combined with adenosine nucleotide levels and differences in tissue architecture. Results Metabolomic analysis revealed significantly higher concentrations of universally labelled lactate in the cortex of HMP/Air vs HMP/O2 kidneys (0.056 mM vs. 0.026 mM, p

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