In JoVE (2)
Articles by J. Moritz Kaths in JoVE
Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation J. Moritz Kaths1,2, Vinzent N. Spetzler1, Nicolas Goldaracena1, Juan Echeverri1, Kristine S. Louis1, Daniel B. Foltys3, Mari Strempel4, Paul Yip5, Rohan John5, Istvan Mucsi1, Anand Ghanekar1, Darius Bagli6,7, Lisa Robinson2, Markus Selzner1 1Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, 2Division of Nephrology, The Hospital for Sick Children, Toronto, 3Department of General, Visceral & Transplant Surgery, University Medical Center Mainz, 4Department of Abdominal, Vascular & Transplant Surgery, Merheim Medical Center Cologne, 5Laboratory Medicine & Pathobiology, Toronto General Hospital, 6Departments of Surgery (Urology) & Physiology, The Hospital for Sick Children, Toronto, 7Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto The severe organ shortage has resulted in increased use of marginal kidney grafts for transplantation. This has triggered interest in alternative storage methods, since marginal grafts especially tolerate cold storage poorly. The technique of normothermic ex vivo kidney perfusion (NEVKP) represents a novel preservation method for kidney grafts prior to transplantation.
Heterotopic Renal Autotransplantation in a Porcine Model: A Step-by-Step Protocol J. Moritz Kaths1,2, Juan Echeverri1,3, Nicolas Goldaracena1, Kristine S. Louis1, Paul Yip4, Rohan John4, Istvan Mucsi5, Anand Ghanekar1, Darius Bagli6, Markus Selzner1, Lisa A. Robinson2 1Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, 2Division of Nephrology, The Hospital for Sick Children, 3Programa de Doctorat en Medicina, La Universitat Autónoma de Barcelona, 4Laboratory Medicine and Pathobiology, Toronto General Hospital, 5Department of Medicine, Toronto General Hospital, 6Departments of Surgery (Urology) & Physiology, Developmental & Stem Cell Biology, The Hospital for Sick Children Porcine models of organ transplantation provide an important platform to study mechanisms of organ preservation. This article describes a heterotopic porcine renal autotransplantation model, which allows investigating new approaches to improve the outcome of transplantation using marginal kidney grafts.
Other articles by J. Moritz Kaths on PubMed
Achalasia with Megaesophagus and Tracheal Compression in a Young Patient: A Case Report International Journal of Surgery Case Reports. 2015 | Pubmed ID: 26209755 Achalasia is one of the most common causes of dysphagia. Typical symptoms include difficulties in controlling the swallowing process, regurgitation, weight loss, and chest pain. A megaesophagus rarely causes tracheal compression with consecutive acute dyspnea or similar respiratory symptoms.
Subnormothermic Ex Vivo Liver Perfusion is a Safe Alternative to Cold Static Storage for Preserving Standard Criteria Grafts Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. Jan, 2016 | Pubmed ID: 26390093 We developed a novel technique of subnormothermic ex vivo liver perfusion (SNEVLP) for the storage of liver grafts before transplantation. To test the safety of SNEVLP for the nonextended criteria grafts (standard grafts), we compared it to a control group with minimal cold static storage (CS) time. Heart-beating pig liver retrieval was performed. Grafts were either stored in cold unmodified University of Wisconsin solution (CS-1), in cold University of Wisconsin solution with ex vivo perfusion additives (CS-2), or preserved with a sequence of 3 hours CS and 3 hours SNEVLP (33°C), followed by orthotopic liver transplantation. Liver function tests and histology were investigated. Aspartate aminotransferase (AST) levels during SNEVLP remained stable (54.3 ± 12.6 U/L at 1 hour to 47.0 ± 31.9 U/L at 3 hours). Posttransplantation, SNEVLP versus CS-1 livers had decreased AST levels (peak at day 1, 1081.9 ± 788.5 versus 1546.7 ± 509.3 U/L; P = 0.14; at day 2, 316.7 ± 188.1 versus 948.2 ± 740.9 U/L; P = 0.04) and alkaline phosphatase levels (peak at day 1, 150.4 ± 19.3 versus 203.7 ± 33.6 U/L; P = 0.003). Bilirubin levels were constantly within the physiological range in the SNEVLP group, whereas the CS-1 group presented a large standard deviation, including pathologically increased values. Hyaluronic acid as a marker of endothelial cell (EC) function was markedly improved by SNEVLP during the early posttransplant phase (5 hours posttransplant, 1172.75 ± 598.5 versus 5540.5 ± 2755.4 ng/mL). Peak international normalized ratio was similar between SNEVLP and CS-1 groups after transplantation. Immunohistochemistry for cleaved caspase 3 demonstrated more apoptotic sinusoidal cells in the CS-1 group when compared to SNEVLP grafts 2 hours after reperfusion (19.4 ± 19.5 versus 133.2 ± 48.8 cells/high-power field; P = 0.002). Adding normothermic CS-2 had no impact on liver injury or function after transplantation when compared to CS-1. In conclusion, SNEVLP is safe to use for standard donor grafts and is associated with improved EC and bile duct injury even in grafts with minimal CS time. Liver Transpl 22:111-119, 2016. © 2015 AASLD.