Longchamp, Alban Klauser, Antoine Songeon, Julien Agius, Thomas Nastasi, Antonio Ruttiman, Raphael Moll, Solange Meier, Raphael P. H. Bühler, Leo Corpataux, Jean-Marc Lazeyras, François 2020 Background: The lack of organs for kidney transplantation is a growing concern. Expansion in organ supply has been proposed through the use of organs after circulatory death (donation after circulatory death [DCD]). However, many DCD grafts are discarded because of long warm ischemia times, and the absence of reliable measure of kidney viability. 31P magnetic resonance imaging (pMRI) spectroscopy is a noninvasive method to detect high-energy phosphate metabolites, such as ATP. Thus, pMRI could predict kidney energy state, and its viability before transplantation.Methods: To mimic DCD, pig kidneys underwent 0, 30, or 60 min of warm ischemia, before hypothermic machine perfusion. During the ex vivo perfusion, we assessed energy metabolites using pMRI. In addition, we performed Gadolinium perfusion sequences. Each sample underwent histopathological analyzing and scoring. Energy status and kidney perfusion were correlated with kidney injury.Results: Using pMRI, we found that in pig kidney, ATP was rapidly generated in presence of oxygen (100 kPa), which remained stable up to 22 h. Warm ischemia (30 and 60 min) induced significant histological damages, delayed cortical and medullary Gadolinium elimination (perfusion), and reduced ATP levels, but not its precursors (AMP). Finally, ATP levels and kidney perfusion both inversely correlated with the severity of kidney histological injury.Conclusions: ATP levels, and kidney perfusion measurements using pMRI, are biomarkers of kidney injury after warm ischemia. Future work will define the role of pMRI in predicting kidney graft and patient’s survival. application/pdf https://folia.unifr.ch/global/documents/308876 https://folia.unifr.ch/documents/308876/files/buh_eva.pdf eng info:eu-repo/semantics/altIdentifier/doi/10.1097/TP.0000000000003323 info:eu-repo/semantics/openAccess License undefined Transplantation. - 2020, vol. 104, no. 9, p. 1825–1831 info:eu-repo/classification/udc/61 Ex vivo analysis of kidney graft viability using 31p magnetic resonance imaging spectroscopy http://purl.org/coar/resource_type/c_6501