Improved preservation strategies for the storage of graft collected after circulatory death could increase the number of kidneys available and improve patient survival. Warm (22 and 37°C) ex-vivo perfusion has emerged as a feasible strategy for organ recovery, but the underlying mechanism remains elusive. Using phosphorus magnetic resonance spectroscopic imaging (31P-MRSI) and histological scoring, we evaluated kidney viability and adenosine triphosphate (ATP) production during sub-normothermic ex-vivo kidney perfusion (SNOP) versus hypothermic machine perfusion (HMP) in a porcine kidney autotransplantation model.
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