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American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
07, 2022;22 (7): 1791-1803.

Machine perfusion combined with antibiotics prevents donor-derived infections caused by multidrug-resistant bacteria.

Han Liang, Peng Zhang, Bin Yu, Zhongzhong Liu, Li Pan, Xueyu He, Xiaoli Fan, Yanfeng Wang
Author Information
  1. Han Liang: Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, Wuhan, Hubei, P.R. China. ORCID
  2. Peng Zhang: Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, Wuhan, Hubei, P.R. China. ORCID
  3. Bin Yu: Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, Wuhan, Hubei, P.R. China. ORCID
  4. Zhongzhong Liu: Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, Wuhan, Hubei, P.R. China.
  5. Li Pan: Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, Wuhan, Hubei, P.R. China.
  6. Xueyu He: Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, Wuhan, Hubei, P.R. China.
  7. Xiaoli Fan: Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, Wuhan, Hubei, P.R. China. ORCID
  8. Yanfeng Wang: Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, Wuhan, Hubei, P.R. China. ORCID
PMID: 35303398 DOI: 10.1111/ajt.17032

Abstract

Donor infection affects organ utilization, especially the infections by multidrug-resistant bacteria, which may have disastrous outcomes. We established a rat model, inoculated with Escherichia coli or carbapenem-resistant Klebsiella pneumoniae (CRKP), to investigate whether hypothermic machine perfusion (HMP), normothermic machine perfusion (NMP), or static cold storage (SCS) combined with antibiotic (AB) could eliminate the bacteria. E. coli or CRKP-infected kidneys were treated with cefoperazone-sulbactam and tigecycline, respectively. The HMP+AB and NMP+AB treatments had significant therapeutic effects on E. coli or CRKP infection compared with the SCS+AB treatment. The bacterial load of CRKP-infected kidneys in the HMP+AB (22 050 ± 2884 CFU/g vs. 1900 ± 400 CFU/g, p = .007) and NMP+AB groups (25 433 ± 2059 CFU/g vs. 500 ± 458 CFU/g, p = .002) were significantly reduced, with no statistically significant difference between both groups. Subsequently, the CRKP-infected kidneys of the HMP+AB and SCS+AB groups were transplanted. The rats in the SCS+AB group were severe infected and euthanized on day 4 post-transplant. By contrast, the rats in the HMP+AB group were in good condition. In conclusion, HMP and NMP combined with AB seems to be efficient approaches to decrease bacterial load of infected kidneys. This might lead to higher utilization rates of donors with active infection.

Keywords

animal models: murine antibiotic: antibacterial artificial organs/support devices basic (laboratory) research/science, infectious disease donors and donation: donor-derived infections kidney disease: infectious kidney transplantation/nephrology solid organ transplantation

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MeSH Term

Animals
Anti-Bacterial Agents
Escherichia coli
Humans
Hypothermia
Organ Preservation
Perfusion
Rats
Tissue Donors

Chemicals

Anti-Bacterial Agents
Journal Article Research Support, Non-U.S. Gov't
Article has an altmetric score of 4

Word Cloud

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