A novel dextran 40-based preservation solution.
Although the University of Wisconsin (UW) solution has become the standard solution for the preservation of kidneys for transplantation, the importance of the colloid hydroxyethylstarch (HES), one of the key compounds of the UW solution, has been questioned repeatedly. It is now established that HES is not necessary for routine kidney preservation. However, colloids may still be advantageous in UW like solutions for the purpose of multiorgan procurements and the preservation of organs from marginal donors. It has been shown in various experimental models that dextran 40 may successfully substitute for HES. Dextran 40 is not only cheaper but also has a variety of biological effects that may be beneficial during the graft reperfusion phase. The aim of this clinical study was to examine the efficacy of a dextran 40-based preservation solution (Dex-PS) for its use in human kidney graft preservation and to compare the transplantation results with kidneys preserved with UW solution. A total of 87 kidneys were preserved with Dex-PS and matched with 87 kidneys preserved with UW solution. Both groups were comparable in terms of donor and recipient characteristics and both had a high proportion of kidneys from nonheart-beating donors. Patient survival and graft survival after 1 year were 95% and 86% for the Dex-PS group and 94% and 90% for the UW group, respectively (P = NS). Primary nonfunction, delayed graft function, postoperative need for dialysis, and follow-up of serum creatinine were statistically comparable between these two groups. We conclude that dextran 40 can safely replace HES in UW solution for the purpose of clinical kidney preservation. There were no statistically detectable differences in graft performance between the kidneys preserved with UW and those preserved with Dex-PS.
Candinas
D
D
Department of Surgery, University of Zurich Hospital, Switzerland.
Largiadèr
F
F
Binswanger
U
U
Sutherland
D E
DE
Schlumpf
R
R
D000241:Adenosine / Q000737:chemistry; D000328:Adult; D000493:Allopurinol / Q000737:chemistry; D003102:Colloids; D003404:Creatinine / Q000097:blood; D003911:Dextrans; D005260:Female; D005978:Glutathione / Q000737:chemistry; D006085:Graft Survival; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives; D007328:Insulin / Q000737:chemistry; D016030:Kidney Transplantation / Q000379:methods* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D011887:Raffinose / Q000737:chemistry; D012996:Solutions
D003102:Colloids; D003911:Dextrans; D006895:Hydroxyethyl Starch Derivatives; D007328:Insulin; D019188:Organ Preservation Solutions; D012996:Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D003404:Creatinine; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose