To identify potentially transplantable organs in a pool of marginal kidneys, 33 porcine slaughterhouse kidneys were perfused for 4 h with whole blood. During the normothermic perfusion, plasma, urine, and tissue samples were taken. Several biomarkers for tubule injury, endothelial activation, and inflammatory response were evaluated for a potential correlation with macroscopic appearance, histology, and filtration activity. Generally, biomarker levels increased during perfusion. TLR-4, EDN-1, and NGAL were not associated with any classification. In contrast, a steeper increase in NAG and IL-6 in plasma correlated with a poor macroscopic appearance at 4 h, indicating a higher inflammatory response in the kidneys with worse macroscopy early on, potentially due to more damage at the tubules. Although long-term effects on the graft could not be assessed in this setting, early observation under machine perfusion with whole blood was feasible. It allowed the assessment of kidneys under conditions comparable to reperfusion. This setting could give surgeons further insight into the quality of marginal kidneys and an opportunity to pre-treat them.

Zusammenfassung Normotherme ex-vivo Nierenperfusion ist eine vielversprechende Technik zur Erhaltung und Bewertung der Vitalität und Viabilität von Organen. Die automatisierte Mehrgrößenregelung des Prozesses erhöht die Betriebssicherheit und erleichtert die Bedienung. Für die beteiligte Regelung von arteriellem Sauerstoff- und Kohlendioxidpartialdruck sind in dieser Arbeit zwei Regelungsstrategien anwendungsorientiert umgesetzt und in Simulationen, sowie im echten Prozess validiert worden. Die Ergebnisse wurden im Kontext bekannter Regelungsstrategien diskutiert.