{"id":20241,"date":"2022-10-26T12:41:49","date_gmt":"2022-10-26T17:41:49","guid":{"rendered":"https:\/\/cdtrp.ca\/en\/?post_type=spucpt&p=20241"},"modified":"2022-10-26T12:41:49","modified_gmt":"2022-10-26T17:41:49","slug":"samrat-ray-3mt","status":"publish","type":"spucpt","link":"https:\/\/cdtrp.ca\/en\/spucpt\/samrat-ray-3mt\/","title":{"rendered":"Samrat Ray 3MT"},"content":{"rendered":"

Samrat Ray’s bio<\/strong><\/p>\n

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I am a National Board certified GI, HPB and Liver transplant surgeon from\u00a0New Delhi India. I am currently pursuing my post doc research fellowship in Establishing machine perfusion in pancreas grafts in the lab of Dr Trevor Reichman and Dr Markus Selzner at the Toronto general hospital, Toronto, Canada. My research focusses on establishing normothermic machine perfusion in porcine pancreatic grafts in 3-day survival models and aiming to replicate the same in human pancreas transplantation in future with an aim to expand the donor pool in pancreas transplantation. Alongside, I also work with the machine perfusion models in porcine liver and kidney grafts and also have been participating in the Human Organox liver trial (Metra study) as a part of my curriculum here at the Toronto organ preservation laboratory.<\/p>\n

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Expanding the donor pool using Normothermic Ex vivo Machine Perfusion model in pancreas transplantation<\/strong><\/p>\n

Catherine Parmentier, Laura Mazilescu, Masataka Kawamura, Yuki Noguchi, Emmanuel Nogueira, Sujani Ganesh, Bhranavi Arulratnam, Sangeetha Kalimuthu, Markus Selzner, Trevor Reichman<\/em><\/p>\n

Introduction: Pancreas transplantation has shown promising results in improving quality of life in diabetes mellitus. However, pancreas grafts are the most discarded grafts from procurement and have the lowest utilization rate (9%) of any organ mainly due to vulnerability of the gland to oedema and ischemia reperfusion injury. Normothermic machine perfusion (NMP) aims to simulate physiological milieu for the organ, ex-vivo as close to homeostasis as possible. We hereby summarise our experience using NMP in porcine and discarded human pancreas grafts so far.<\/p>\n

Methods: Using a S3 heart-lung machine and neonatal cardiopulmonary bypass equipment with a normothermic perfusion solution and dialysing system, our laboratory established 3-day NMP survival model using porcine pancreata, harvested from 15-week-old Yorkshire pigs. Similar perfusion protocol was replicated for discarded human pancreas grafts to establish feasibility.<\/p>\n

Results: 12 porcine pancreases were subjected to NMP alone for 3 hrs after minimal cold storage, using the modified perfusate (9% CO2) and dialysate (1.5 gm\/L salt) recipe. Based on the favourable results of the same (average peak 3 hr amylase: 5500 U\/L), transplantation was carried out in 3-day survival models (n=4). All animals survived till 3 days with acceptable glucose levels (average peak on Day 1= 6.4 mmol\/l) and normal glucose tolerance test on Day 3. Among the human grafts, 5 were from brain dead donors and 1 from a cardiac death donor. Glucose levels decreased during the perfusion (average peak: 9mmol\/l; 3.9-19.6) and insulin levels increased (average peak: 1688.4 pmol\/l; 7-4304 pmol\/L). All grafts (human and porcine) were metabolically active during perfusion and histopathology showed minimal tissue injury.<\/p>\n

Conclusion: Establishing optimal conditions for NMP is a challenge for pancreas grafts. However, meticulous cold dissection, minimum handling of organ while on the machine along with a relatively hyperosmolar composition of the dialysing solution has shown promising results.<\/p>\n","protected":false},"author":6,"template":"","class_list":["post-20241","spucpt","type-spucpt","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/spucpt\/20241"}],"collection":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/spucpt"}],"about":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/types\/spucpt"}],"author":[{"embeddable":true,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/users\/6"}],"wp:attachment":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/media?parent=20241"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}