Protection of autotransplanted pig kidneys from ischemia-reperfusion injury by polyethylene glycol.
BACKGROUND
Ischemia-reperfusion injury (IRI) is often responsible for graft rejection and leads to delayed graft function of cadaveric kidneys. We have shown that adding polyethylene glycol (PEG 20M) to the preservation solutions helps protect isolated perfused pig kidneys against cold ischemia and reperfusion injury.


METHODS
We compared the effects of adding PEG to a simplified high-K+ perfusion solution of cold-stored kidneys to Euro-Collins or University of Wisconsin solutions on the function of reperfused autotransplanted pig kidneys. The left kidney was cold-flushed with the preservation solutions and stored for 48 hr at 4 degrees C before reimplantation. Creatinine clearance and fractional excretion of sodium were analyzed 2 days before surgery and over 7 days after transplantation. Histological sections were obtained 40 min after reperfusion and on day 7 after surgery.


RESULTS
Adding PEG to the perfusate significantly reduced IRI from autotransplanted pig kidneys. Creatinine clearance was significantly higher and fractional excretion of sodium was significantly lower in pigs transplanted with kidneys cold-flushed with PEG-supplemented perfusate than in those flushed with Euro-Collins or University of Wisconsin solutions. PEG supplementation also better preserved the integrity of kidney cells and markedly reduced interstitial cell infiltrates.


CONCLUSIONS
PEG protects against IRI and reduces early cellular inflammation. PEG may impair the recruitment and migration of leukocytes into retransplanted pig kidneys. Cold preservation of donor organs with PEG-supplemented solutions may therefore help limit IRI in human renal transplantation.
Hauet
T
T
Département de Génétique Animale, Institut National de Recherche Agronomique, Domaine du Magneraud, Surgères, France. hauet@magneraud.inra.fr
Baumert
H
H
Amor
I B
IB
Goujon
J M
JM
Gibelin
H
H
Godart
C
C
Vandewalle
A
A
Carretier
M
M
Eugene
M
M
D000818:Animals; D006085:Graft Survival / Q000187:drug effects; D007668:Kidney / Q000187:drug effects / Q000502:physiology; D016030:Kidney Transplantation / Q000276:immunology; D019188:Organ Preservation Solutions / Q000737:chemistry; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D015427:Reperfusion Injury / Q000517:prevention & control*; D013552:Swine; D014182:Transplantation, Autologous
D019188:Organ Preservation Solutions; D011092:Polyethylene Glycols