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Abstract: SA-OR62

Deceased Donor Kidney Function Is Determined by Branch Chained Amino Acid Metabolism During Ex Vivo Normothermic Perfusion

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Ahmadi, Armin, University of California Davis, Davis, California, United States
  • Yu, Jacquelyn M., University of California Davis, Davis, California, United States
  • Loza, Jennifer, University of California Davis, Davis, California, United States
  • Howard, Brian Christopher, University of California Davis, Davis, California, United States
  • Than, Peter, University of California Davis, Davis, California, United States
  • Goussous, Naeem, University of California Davis, Davis, California, United States
  • Sageshima, Junichiro, University of California Davis, Davis, California, United States
  • Roshanravan, Baback, University of California Davis, Davis, California, United States
  • Perez, Richard V., University of California Davis, Davis, California, United States
Background

Current kidney perfusion protocols are not optimized for addressing ex vivo physiological and metabolic needs of the kidney. We studied kidney function parameters and their link with metabolic competence during a 12-hour ex vivo normothermic perfusion (EVNP).

Methods

Eight human kidneys from deceased donors deemed unsuitable for transplantation were preserved using 12 hours of EVNP during which markers of function and injury were monitored. Kidneys were grouped into good and poor performers based on their functional parameters. Metabolic profile from kidney cortex samples were obtained throughout the perfusion.

Results

The mean age of the deceased kidney donors was 43 ± 16 yrs with a mean cold ischemia time of 37 ± 12 hrs. Hemodynamics parameters such as urine output (mean=99.5 ml/hr) and creatinine clearance (mean=32.6 ml/min) progressively increased and peaked at 6 hours post perfusion among good performers (Figure 1). Urinary neutrophil gelatinase-associated lipocalin was also significantly different at 6 hours between the two groups (mean difference=85.8 ng/ml, P=0.02) (Figure 1B). Peak functional differences at 6 hours coincided with tissue accumulation of branch chain amino acids (BCAA) among poor performers compared to good performers (Figure 2).

Conclusion

We identified impaired BCAA metabolism at 6 hours of EVNP as the metabolic phenotype distinguishing poor and good performing kidneys. Future studies with larger sample sizes are needed to validate the association of impaired BCAA metabolism with kidney functional decline.

Figure 1. Functional parameters comparing poor and good performers.

Figure 2. Tissue BCAA levels among poor and good performers.

Funding

  • NIDDK Support