Perfusate lactate dehydrogenase level and intrarenal resistance could not be adequate markers of perfusion quality during isolated kidney perfusion.
The main goal of this work was to study the influence of perfusion pressure and flow waveform during kidney perfusion, and the relationship between renal vascular resistance (RVR) and lactate dehydrogenase (LDH) concentration in the perfusate. Simultaneous constant pressure kidney perfusions were performed with either pulsatile or continuous flow at either 30 or 80 mm Hg of constant perfusion pressure. Mean flow, pressure, and RVR were displayed online during perfusion. Perfusate samples for LDH, creatine phosphatase kinase (CPK), and alkaline phosphatase (AP) determinations were taken. At the end of the perfusion, 2 ml of Evans blue was injected into the circuit to obtain images of perfusate distribution, and the kidneys were weighed. Also, hematoxylin/eosine studies were performed, showing more Bowman's space and tubular dilation in kidneys perfused with high pressure. We did not find differences in RVR between kidneys perfused at 30 and 80 mm Hg; nevertheless, perfusate distribution was better in the 80 mm Hg perfusions. We did not find any correlation between enzyme release and RVR in kidneys perfused with different mean pressures. These findings suggest that vascular resistance and LDH concentration cannot be independently considered as adequate markers of perfusate distribution.
Herrera
B
B
Unidad de Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Alcorcón, Madrid, Spain.
Eisenberg
G
G
Desco
M M
MM
Holberndt
O
O
Rábano
A
A
Castilla
M
M
García-Barreno
P
P
Del Cañizo
J F
JF
D000469:Alkaline Phosphatase / Q000032:analysis; D000818:Animals; D015415:Biomarkers / Q000032:analysis; D004396:Coloring Agents; D003402:Creatine Kinase / Q000032:analysis; D005163:Factor Analysis, Statistical; D007668:Kidney / Q000098:blood supply / Q000201:enzymology*; D007678:Kidney Glomerulus / Q000033:anatomy & histology; D007684:Kidney Tubules / Q000033:anatomy & histology; D007770:L-Lactate Dehydrogenase / Q000032:analysis*; D009862:Online Systems; D009926:Organ Preservation / Q000379:methods*; D009929:Organ Size; D010477:Perfusion / Q000379:methods*; D011312:Pressure; D011673:Pulsatile Flow; D011897:Random Allocation; D012212:Rheology; D013552:Swine; D013556:Swine, Miniature; D014655:Vascular Resistance / Q000502:physiology*
D015415:Biomarkers; D004396:Coloring Agents; D007770:L-Lactate Dehydrogenase; D003402:Creatine Kinase; D000469:Alkaline Phosphatase