Toronto General Hospital 7 articles published in JoVE Medicine Normothermic Ex Vivo Pancreas Perfusion for the Preservation of Pancreas Allografts before Transplantation Catherine Parmentier1, Samrat Ray1, Laura Mazilescu1,2, Masataka Kawamura1, Yuki Noguchi1, Emmanuel Nogueira1, Sujani Ganesh1, Bhranavi Arulratnam1, Sangeetha Kalimuthu3, Markus Selzner1, Trevor Reichman1 1Ajmera Transplant Program, University Health Network, Toronto General Hospital, 2Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, 3Department of Pathology, University Health Network, Toronto General Hospital Normothermic ex vivo machine perfusion (NEVP) has scarcely been explored for the preservation of pancreas allografts. We present an innovative preservation technique for pancreas allografts before transplantation. Medicine Large-Animal Model of Donation after Circulatory Death and Normothermic Regional Perfusion for Cardiac Assessment Khalil Khalil*1,2, Roberto V. P. Ribeiro*3, Julgans S. Alvarez4,5, Mitesh V. Badiwala4,5, Shant Der Sarkissian1,2, Nicolas Noiseux1,2 1 The protocol describes a large-animal (porcine) model of donation after circulatory death, followed by thoracoabdominal normothermic regional perfusion that closely simulates the clinical scenario in heart transplantation, and has the potential to facilitate therapeutic studies and strategies. Medicine Using a Chemical Biopsy for Graft Quality Assessment Iga Stryjak*1, Natalia Warmuzińska*1, Kamil Łuczykowski1, Matyas Hamar2, Peter Urbanellis2, Emilia Wojtal3, Marek Masztalerz3, Markus Selzner2,4, Zbigniew Włodarczyk3, Barbara Bojko1 1Department of Pharmacodynamics and Molecular Pharmacology, Faculty of Pharmacy, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 2Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, University Health Network, 3Department of Transplantology and General Surgery, Collegium Medicum in Bydgoszcz, Antoni Jurasz University Hospital No. 1 in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland, 4Department of Medicine, Toronto General Hospital The protocol presents utilization of the chemical biopsy approach followed by comprehensive metabolomic and lipidomic analysis for quality assessment of kidney grafts allocated for transplantation. Medicine 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. Medicine 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. Medicine Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt Vinzent N. Spetzler1, Nicolas Goldaracena1, Jan M. Knaak1, Kristine S. Louis1, Nazia Selzner1, Markus Selzner1 1Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital Experimental animal research plays a pivotal role in the development of clinical transplantation practice. The porcine orthotopic liver transplantation model (OLTx) closely resembles human conditions and is frequently used in clinically oriented research. The following protocol contains all information for a reliable porcine OLTx model using an active porto-caval-jugular shunt. Medicine Technique of Subnormothermic Ex Vivo Liver Perfusion for the Storage, Assessment, and Repair of Marginal Liver Grafts Jan M. Knaak*1,2, Vinzent N. Spetzler*1,2, Nicolas Goldaracena1,2, Kristine S. Louis1,2, Nazia Selzner1,3, Markus Selzner1,2 1Multi Organ Transplant Program, Toronto General Hospital, 2Department of Surgery, Toronto General Hospital, 3Department of Medicine, Toronto General Hospital Marginal grafts, such as fatty livers, grafts from older donors, or livers retrieved after cardiac death (DCD) tolerate conventional, cold static storage only poorly. We developed a novel model of subnormothermic ex vivo liver perfusion for preservation, assessment, and repair of marginal liver grafts prior to transplantation.
