{
    "abstract": "Acceptance criteria of deceased donor organs have gradually been extended toward suboptimal quality, posing an urgent need for more objective pre-transplant organ assessment. Ex vivo normothermic machine perfusion (NMP) combined with magnetic resonance imaging (MRI) could assist clinicians in deciding whether a donor kidney is suitable for transplantation. Aim of this study was to characterize the regional distribution of perfusate flow during NMP, to better understand how ex\u00a0vivo kidney assessment protocols should eventually be designed. Nine porcine and 4 human discarded kidneys underwent 3\u00a0h of NMP in an MRI-compatible perfusion setup. Arterial spin labeling scans were performed every 15\u00a0min, resulting in perfusion-weighted images that visualize intrarenal flow distribution. At the start of NMP, all kidneys were mainly centrally perfused and it took time for the outer cortex to reach its physiological dominant perfusion state. Calculated corticomedullary ratios based on the perfusion maps reached a physiological range comparable to in\u00a0vivo observations, but only after 1 to 2\u00a0h after the start of NMP. Before that, the functionally important renal cortex appeared severely underperfused. Our findings suggest that early functional NMP quality assessment markers may not reflect actual physiology and should therefore be interpreted with caution.",
    "authors": [
        {
            "affiliation": "Department of Surgery - Organ Donation and Transplantation, University of Groningen, University Medical Center, Groningen, The Netherlands.",
            "firstname": "Rianne",
            "initials": "R",
            "lastname": "Schutter"
        },
        {
            "affiliation": "Department of Surgery - Organ Donation and Transplantation, University of Groningen, University Medical Center, Groningen, The Netherlands.",
            "firstname": "Veerle A",
            "initials": "VA",
            "lastname": "Lantinga"
        },
        {
            "affiliation": "Department of Surgery - Organ Donation and Transplantation, University of Groningen, University Medical Center, Groningen, The Netherlands.",
            "firstname": "Tim L",
            "initials": "TL",
            "lastname": "Hamelink"
        },
        {
            "affiliation": "Department of Surgery - Organ Donation and Transplantation, University of Groningen, University Medical Center, Groningen, The Netherlands.",
            "firstname": "Merel B F",
            "initials": "MBF",
            "lastname": "Pool"
        },
        {
            "affiliation": "Department of Surgery - Organ Donation and Transplantation, University of Groningen, University Medical Center, Groningen, The Netherlands.",
            "firstname": "Otis C",
            "initials": "OC",
            "lastname": "van Varsseveld"
        },
        {
            "affiliation": "Department of Radiology, University of Groningen, University Medical Center, Groningen, The Netherlands.",
            "firstname": "Jan Hendrik",
            "initials": "JH",
            "lastname": "Potze"
        },
        {
            "affiliation": "Department of Pathology & Medical Biology, University of Groningen, University Medical Center, Groningen, The Netherlands.",
            "firstname": "Jan-Luuk",
            "initials": "JL",
            "lastname": "Hillebrands"
        },
        {
            "affiliation": "Department of Pathology & Medical Biology, University of Groningen, University Medical Center, Groningen, The Netherlands.",
            "firstname": "Marius C",
            "initials": "MC",
            "lastname": "van den Heuvel"
        },
        {
            "affiliation": "Department of Radiology, University of Groningen, University Medical Center, Groningen, The Netherlands.\nDepartment of Nuclear Medicine, University of Groningen, University Medical Center, Groningen, The Netherlands.",
            "firstname": "Rudi A J O",
            "initials": "RAJO",
            "lastname": "Dierckx"
        },
        {
            "affiliation": "Department of Surgery - Organ Donation and Transplantation, University of Groningen, University Medical Center, Groningen, The Netherlands.",
            "firstname": "Henri G D",
            "initials": "HGD",
            "lastname": "Leuvenink"
        },
        {
            "affiliation": "Department of Surgery - Organ Donation and Transplantation, University of Groningen, University Medical Center, Groningen, The Netherlands.",
            "firstname": "Cyril",
            "initials": "C",
            "lastname": "Moers"
        },
        {
            "affiliation": "Department of Radiology, University of Groningen, University Medical Center, Groningen, The Netherlands.\nDepartment of Nuclear Medicine, University of Groningen, University Medical Center, Groningen, The Netherlands.",
            "firstname": "Ronald J H",
            "initials": "RJH",
            "lastname": "Borra"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2021 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT.",
    "doi": "10.1111/tri.13991",
    "journal": "Transplant international : official journal of the European Society for Organ Transplantation",
    "keywords": [
        "arterial spin labeling",
        "kidney",
        "machine perfusion",
        "magnetic resonance imaging",
        "transplantation"
    ],
    "methods": null,
    "publication_date": "2021-08-28",
    "pubmed_id": "34448269\n27764031\n24506794\n22188574\n19118301\n31087667\n28115329\n29878499\n29210064\n28889600\n29977584\n33220737\n30461718\n30171799\n30951018\n23731682\n20965955\n19345683\n20850241\n31046189\n22958717\n20512866\n16439565\n9673811\n23728972\n22080855\n12529271\n26474973\n32897651\n14416431\n23167537\n24944913\n28399018\n30137579\n30137581\n30102436",
    "results": null,
    "title": "Magnetic resonance imaging assessment of renal flow distribution patterns during ex\u00a0vivo normothermic machine perfusion in porcine and human kidneys.",
    "xml": "<Element 'PubmedArticle' at 0x7885046046d0>"
}