Improved porcine renal preservation with a simple extracellular solution--PBS140.
In this prospective randomized trial a porcine model of renal autotransplantation was used to compare quality of preservation, as reflected by detailed analysis of posttransplant renal function, following 24-hr cold storage in phosphate-buffered sucrose (PBS140), hyperosmolar citrate (HOC), and University of Wisconsin (UW) preservation solutions. There were 6 deaths with primary nonfunction: 3 of 5 HOC, 2 of 5 UW, but only 1 of 5 PBS140. Analysis of the whole group and separate analysis of the survivors demonstrated significantly better renal function following preservation with PBS140 when compared with both HOC and UW, with a lower peak serum creatinine (P = 0.02) and improved loop of Henle function (P = 0.02). The animals in the PBS140 group also demonstrated a more rapid return to normal creatinine, higher GFR, improved tubular function, and higher effective renal plasma flow, with figures approaching statistical significance (P = 0.06-0.07). The proposal of UW as a universal storage medium prompted this study, and its results suggest the need for a clinical comparison of renal preservation using UW and PBS140 in a prospective randomized trial.
Lodge
J P
JP
University Department of Surgery, St. James's University Hospital, United Kingdom.
Perry
S L
SL
Skinner
C
C
Potts
D J
DJ
Giles
G R
GR
D000241:Adenosine; D000493:Allopurinol; D000818:Animals; D001835:Body Weight; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D005978:Glutathione; D007328:Insulin; D016030:Kidney Transplantation / Q000502:physiology*; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D009929:Organ Size; D011887:Raffinose; D012996:Solutions; D013403:Sugar Phosphates; D013552:Swine; D014182:Transplantation, Autologous
D007328:Insulin; D019188:Organ Preservation Solutions; D012996:Solutions; D013403:Sugar Phosphates; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D003404:Creatinine; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose