Пример из практики, нормотермический аппарат для перфузии и адсорбции

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Normothermic Machine Perfusion and Inflflammatory Mediators Adsorp8on: First Kidney Transplant Experience

Pagano D, Busa R, Lo Pinto M,Jukna A, Vella I, Calamia S, Piazza S, Salis P, Buscemi B, Conaldi PG, Agnese V, Pinzani M, di Francesco F, Petri SL, Scilabra SD, GruBadauria S.ASAIO Journal 2025; epub

Kidney Transplant / Ex-vivo Perfusion / PerSorb (CytoSorbents)

Procedure: A 75-year-old donor kidney underwent 320 minutes of ex-vivo normothermic machine perfusion (NMP) with the PerSorb® (CytoSorbents) device, designed to adsorb inflammatory cytokines (e.g., interleukin IL-6, IL-8, MCP-1) via size exclusion and hydrophobic interaction for extended criteria donor (ECD) organs.

Key Findings:

• Effective cytokine removal was achieved without sorbent saturation, despite rising inflammatory levels during perfusion.

• Urine output was high during perfusion, and no delayed graft dysfunction (DGF) occurred posttransplant.

• Post-transplant outcomes were favorable, with the recipient stable and well at 6-month followup.

Cytokine Profile:

• Pro-inflammatory cytokines increased, while anti-inflammatory mediators like IL-10 and HGF decreased—indicating concentration-dependent modulation.

• Mass balance (MB) analysis confirmed active cytokine adsorption, offering better insight than systemic trend observation alone.

Proteomic Analysis:

• 331 proteins identified, with minimal non-cytokine reduction, reinforcing cytokine selectivity of the device.

• Proteins mainly belonged to complement and coagulation cascades.

Clinical Relevance:

• The combination of NMP and PerSorb® appears safe, feasible, and potentially effective for reducing ischemia-reperfusion injury (IRI) in ECD kidneys.

• This technique may help "recondition" suboptimal grafts, improving post-transplant outcomes.

• The kidney was transplanted without delayed graft dysfunction, and the recipient had excellent outcomes at six months.

Conclusion: PerSorb® during NMP shows strong potential for enhancing extended criteria donor organ kidney viability and recovery. While results are promising, larger clinical trials are needed to confirm long-term benefits and expand clinical use.

CytoSorbents comment: PerSorb® is a hemoadsorp^on column technically based on CytoSorb®, and manufactured by CytoSorbents USA specififically for use within ex-vivo perfusion circuits.