Novel delivery of cellular therapy to reduce ischemia reperfusion injury in kidney transplantation

Abstract

Ex vivo normothermic machine perfusion (NMP) of donor kidneys prior to transplantation provides a platform for direct delivery of cellular therapeutics to optimize organ quality prior to transplantation. Multipotent Adult Progenitor Cells (MAPC®) possess potent immunomodulatory properties that could minimize ischemia reperfusion injury. We investigated the potential capability of MAPC cells in kidney NMP. Pairs (5) of human kidneys, from the same donor, were simultaneously perfused for 7 hours. Kidneys were randomly allocated to receive MAPC treatment or control. Serial samples of perfusate, urine, and tissue biopsies were taken for comparison. MAPC-treated kidneys demonstrated improved urine output (P =.009), decreased expression of injury biomarker NGAL (P =.012), improved microvascular perfusion on contrast-enhanced ultrasound (cortex P =.019, medulla P =.001), downregulation of interleukin (IL)-1β (P =.050), and upregulation of IL-10 (P