With oxygenation proposed as a resuscitative measure during hypothermic models of preservation, the aim of this study was to evaluate the optimal start time of oxygenation during continuous hypothermic machine perfusion (HMP). In this porcine ischemia‐reperfusion autotransplant model, the left kidney of a ±40 kg pig was exposed to 30 minutes of warm ischemia prior to 22 hours of HMP and autotransplantation. Kidneys were randomized to receive 2 hours of oxygenation during HMP either at the start (n = 6), or end of the perfusion (n = 5) and outcomes were compared to standard, nonoxygenated HMP (n = 6) and continuous oxygenated HMP (n = 8). The brief initial and continuous oxygenated HMP groups were associated with superior graft recovery compared to either standard, nonoxygenated HMP or kidneys oxygenated at the end of HMP. This correlated with significant metabolic differences in perfusate (eg, lactate, succinate, flavin mononucleotide) and tissues (eg, succinate, adenosine triphosphate, hypoxia‐inducible factor‐1α, nuclear factor erythroid 2‐related factor 2) suggesting superior mitochondrial preservation with initial oxygenation. Brief initial O₂ uploading during HMP at procurement site might be an easy and effective preservation strategy to maintain aerobic metabolism, protect mitochondria, and achieve an improved early renal graft function compared with standard HMP or oxygen supply shortly at the end of HMP preservation.

中文翻译：

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在连续低温机器灌注过程中短暂加载 O2 是一种简单而有效的充氧方法，可改善猪自体移植模型的初始肾功能。

在低温保存模型中提出氧合作为复苏措施，本研究的目的是评估连续低温机器灌注 (HMP) 过程中氧合的最佳开始时间。在这种猪缺血再灌注自体移植模型中，在 22 小时的 HMP 和自体移植之前，±40 公斤猪的左肾暴露于 30 分钟的热缺血。在 HMP 期间，肾脏在灌注开始时（n = 6）或结束时（n = 5）随机接受 2 小时的氧合，并将结果与​​标准、非氧合 HMP（n = 6）和连续氧合 HMP 进行比较（ n = 8). 与标准、非充氧 HMP 或在 HMP 结束时充氧的肾脏相比，短暂的初始和持续充氧 HMP 组与更好的移植恢复相关。这与灌注液（例如，乳酸、琥珀酸盐、黄素单核苷酸）和组织（例如，琥珀酸盐、三磷酸腺苷、缺氧诱导因子-1α、核因子红细胞 2 相关因子 2）的显着代谢差异相关，表明初始线粒体保存更优充氧。简短的首字母O₂在采购地点的 HMP 期间上传可能是一种简单有效的保存策略，与标准 HMP 或在 HMP 保存结束时不久供氧相比，可以维持有氧代谢、保护线粒体并实现改善的早期肾移植功能。