A5086793249- Organ Transplantation Techniques and Outcomes
- Organ Donation and Transplantation
- Renal Transplantation Outcomes and Treatments
- Liver Disease and Transplantation
- Cardiac Ischemia and Reperfusion
- Transplantation: Methods and Outcomes
- Renal and Vascular Pathologies
- Acute Kidney Injury Research
- Anesthesia and Neurotoxicity Research
- Cardiac Arrest and Resuscitation
- Cytomegalovirus and herpesvirus research
- Heme Oxygenase-1 and Carbon Monoxide
- Xenotransplantation and immune response
- Neonatal Health and Biochemistry
- Erythropoietin and Anemia Treatment
- Sulfur Compounds in Biology
- MicroRNA in disease regulation
- Tissue Engineering and Regenerative Medicine
- Diabetes and associated disorders
- Thermal Regulation in Medicine
- Cardiac, Anesthesia and Surgical Outcomes
- Neurological Complications and Syndromes
- Diversity and Career in Medicine
- Renal and related cancers
- Mesenchymal stem cell research
University of Cambridge
2016-2025
Addenbrooke's Hospital
2015-2024
RELX Group (United States)
2022
NIHR Cambridge Biomedical Research Centre
2015-2021
National Institute for Health Research
2015-2021
NHS Blood and Transplant
2021
Leicester General Hospital
2009-2019
University of Leicester
2010-2019
Cochrane
2019
Colciencias
2019
A decision to withdraw life-sustaining treatment (WLST) is derived by a conclusion that further will not enable patient survive or produce functional outcome with acceptable quality of life the and treating team regard as beneficial. Although many hospitalized patients die under such circumstances, controlled donation after circulatory determination death (cDCDD) programs have been developed only in reduced number countries. This International Collaborative Statement aims at expanding cDCDD...
Kidney transplantation is the optimal treatment for end-stage renal disease, but it still severely limited by a lack of suitable organ donors. Kidneys from donation after circulatory death (DCD) donors have been used to increase transplant rates, these organs are susceptible cold ischemic injury in storage period before transplantation, clinical consequence which high rates delayed graft function (DGF). Normothermic machine perfusion (NMP) an emerging technique that circulates warmed,...
Background. Normothermic perfusion is an alternative but little studied method of organ preservation. Herein, we report the first case ex vivo normothermic renal transplant in man. Methods. The 62-year-old extended criteria donor died intracranial hemorrhage and had undergone cardiopulmonary resuscitation for a 30-min cardiac arrest. After 11 hr static cold storage immediately before transplantation, left kidney was perfused at mean temperature 33.9°C 35 min with plasma-free red cell-based...
A significant proportion of donation after circulatory death (DCD) kidneys are declined for transplantation because concerns over their quality. Ex vivo normothermic machine perfusion (NMP) provides a unique opportunity to assess the quality kidney and determine its suitability transplantation.In phase 1 this study, human DCD underwent NMP assessment 60 min. Kidneys were graded 1-5 using score (QAS) based on macroscopic perfusion, renal blood flow urine output during NMP. In 2 assessed by...
Ex vivo normothermic perfusion (EVNP) is a novel technique that reconditions the kidney and restores renal function prior to transplantation. Phase I data from series of EVNP in extended criteria donor kidneys have established safety feasibility clinical practice.This UK-based phase II multicentre randomised controlled trial assess efficacy compared with conventional static cold storage donation after circulatory death (DCD) 400 patients receiving DCD (categories III IV, controlled) will be...
Abstract Background A significant proportion of kidneys procured for transplantation are discarded because concerns about their suitability. In this study ex vivo normothermic perfusion (EVNP) was used as a quality assessment device before renal transplantation. Methods Seventy-four human deemed unsuitable following retrieval underwent 60 min EVNP with an oxygenated red cell-based solution at 36°C. Receiver operating characteristic (ROC) curves were to identify thresholds blood flow and...
Anti-CD31 antibody conjugation can enhance nanoparticle accumulation in the vascular endothelium of human kidneys during ex vivo normothermic machine perfusion.
We report the successful transplantation of a pair human kidneys that were declined for due to inadequate in situ perfusion but subsequently transplanted after and assessment using ex vivo normothermic (EVNP). The from 35-year-old man, donation circulatory death donor. Both by all UK transplant centers. On arrival, had significant areas incomplete clearance blood microcirculation did not clear further attempt flush them. Kidneys underwent 60 min EVNP with an oxygenated packed red cell–based...
Abstract ABO blood group compatibility restrictions present the first barrier to donor-recipient matching in kidney transplantation. Here, we use of two enzymes, Fp GalNAc deacetylase and Galactosaminidase, from bacterium Flavonifractor plautii enzymatically convert A antigens renal vasculature human kidneys ‘universal’ O-type. Using normothermic machine perfusion (NMP) hypothermic (HMP) strategies, demonstrate antigen loss approximately 80% as little 2 h NMP HMP. Furthermore, show that...
Abstract Background Normothermic perfusion (NP) has the potential to improve metabolic support and maintain viability of ischaemically damaged organs. This study investigated effects NP compared with current methods organ preservation in a model controlled non-heart-beating donor (NHBD) kidneys. Methods Porcine kidneys (n = 6 each group) were subjected 10 min warm ischaemia then preserved as follows: 2 h cold storage (CS) ice (CS2 group), 18 CS (CS18 machine (CP or 16 + (NP group). Renal...
Background Laparoscopic surgery reduces pain after donor nephrectomy; however, most patients still require a significant amount of postoperative parenteral opiate analgesia. Therefore, there is need to investigate techniques that might further reduce pain. This study assessed the safety and efficacy using transversus abdominis plane (TAP) block in randomized, double-blind, placebo-controlled trial. Methods Forty-six were analyzed trial randomized undergo TAP procedure with either bupivacaine...
Ex vivo normothermic machine perfusion (NMP) of donor kidneys prior to transplantation provides a platform for direct delivery cellular therapeutics optimize organ quality transplantation. Multipotent Adult Progenitor Cells (MAPC® ) possess potent immunomodulatory properties that could minimize ischemia reperfusion injury. We investigated the potential capability MAPC cells in kidney NMP. Pairs (5) human kidneys, from same donor, were simultaneously perfused 7 hours. Kidneys randomly...
Renal ischemia reperfusion (IR) injury leads to significant patient morbidity and mortality, its amelioration is an urgent unmet clinical need. Succinate accumulates during oxidation by the mitochondrial enzyme succinate dehydrogenase (SDH) drives ROS production that underlies IR injury. Consequently, compounds inhibit SDH may have therapeutic potential against renal Among these, competitive inhibitor malonate, administered as a cell-permeable malonate ester prodrug, has shown promise in...
Flavin mononucleotide (FMN), released from damaged mitochondrial complex I during hypothermic liver perfusion, has been shown to be predictive of 90-day graft loss. Normothermic machine perfusion (NMP) and normothermic regional (NRP) are used for organ reconditioning quality assessment before transplantation. This pilot study aimed investigate the changes FMN levels reperfusion kidneys, livers, lungs examine whether could serve as a biomarker predict posttransplant allograft quality.FMN...
Transplantation is the optimal treatment for most patients with end-stage kidney disease but organ shortage a major challenge. Normothermic machine perfusion (NMP) has been used to recondition marginal organs; however, mechanisms by which NMP might benefit organs are not well understood. Using pairs of human kidneys obtained from same donor, we compared effect that cold storage on global transcriptome. We found led reduction in gene expression, including inflammatory pathway genes and those...
Thousands of kidneys from higher-risk donors are discarded annually because the increased likelihood complications posttransplant. Given severe organ shortage, there is a critical need to improve utilization these organs. To this end, normothermic machine perfusion (NMP) has emerged as platform for ex vivo assessment and potential repair marginal In recent study 8 transplant-declined human on NMP, we discovered microvascular obstructions that impaired blood flow. However, nature physiologic...
Abstract Background Therapies to alleviate ischaemia–reperfusion (IR) injury have an important role in kidney transplantation. This study used a porcine model of non-heart-beating (NHB) donor kidneys investigate the effects hydrogen sulphide on IR injury. Methods Porcine were subjected 25 min warm ischaemia and 18 h cold storage. They reperfused ex vivo with autologous oxygenated blood assess renal function. A group treated (0·5 mmol/l) infused 10 before after reperfusion (n = 6) was...