High osmolality-low pH flush solutions improve renal transplant function in rats.
Although transplanting rat kidneys is an established microsurgical technique, inulin clearance is abnormally low, due to rejection and/or warm ischemia-induced damage. In the present studies, rejection was avoided by using inbred Brown Norway rats as donors and recipients. Donor kidneys were flushed with ice-cold solutions of various composition (saline, saline + 200 or 400 mM mannitol) and pHs (5.7, 6.4, and 7.4), and the kidneys were kept cold during transplantation into unilaterally nephrectomized recipients. Renal function was assessed by clearance techniques 1 week later. In control rats, with both native kidneys intact, the ratio of inulin clearance, left kidney to right kidney, was 0.99 +/- 0.02. In rats with a native right kidney and a transplanted left kidney that had been flushed with saline, the ratio was considerably lower (0.46 +/- 0.09). Adding 200 mM mannitol to the saline flush solution increased the ratio (0.89 +/- 0.09). In comparison, adding 200 mM mannitol and 5 mM phosphate buffer at pH 7.4 resulted in a somewhat lower ratio (0.80 +/- 0.09), whereas adding 200 mM mannitol and 5 mM phosphate buffer at pH 5.7 resulted in a higher ratio, one that was indistinguishable from control (0.97 +/- 0.09). Thus, in this latter group, the inulin clearances of the transplanted kidneys were identical to those of the contralateral native kidneys.
Kline
R
R
Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan.
Churchill
M
M
Churchill
P
P
Bidani
A
A
Schwartz
M
M
D000818:Animals; D006863:Hydrogen-Ion Concentration; D007444:Inulin; D007552:Isotonic Solutions; D007668:Kidney; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000502:physiology*; D008353:Mannitol / Q000627:therapeutic use; D009926:Organ Preservation / Q000379:methods*; D009994:Osmolar Concentration; D051381:Rats; D011914:Rats, Inbred BN; D015427:Reperfusion Injury / Q000517:prevention & control
D007552:Isotonic Solutions; D008353:Mannitol; D007444:Inulin