A modified University of Wisconsin preservation solution with high-NA+ low-K+ content reduces reperfusion injury of the pig kidney graft.
BACKGROUND
Ischemia-reperfusion injury has been associated with both early and late effects on allografts in the form of delayed graft function and decreased graft survival. Recent studies demonstrated that functional parameters were influenced by cold storage conditions and particularly the ratio of Na+:K+ of the preservation solution.


METHODS
We have extended this study to examine whether the high-Na+ low-K+ formulation of Belzer's solution (HEH) was efficient in an autotransplanted pig kidney model when compared with the classical low-Na+ high-K+ University of Wisconsin solution and the new high-Na+ low-K+ Celsior solution. Kidneys were harvested, cold flushed, and preserved for 24, 48, or 72 hr with HEH, Celsior solution, or University of Wisconsin solution and autotransplanted. Renal function was determined on days 1, 3, 7, and 14, and at 4 to 16 weeks after autotransplantation. Histologic changes and cell infiltration were assessed on kidney biopsy specimens taken after reperfusion (30-40 min), at days 5 and 14, and at 4 to 5 and 10 to 12 weeks after surgery. Peripheral benzodiazepine receptor (PBR), a structural mitochondrial protein, was also studied.


RESULTS
Cold storage in HEH resulted in reduction of delayed graft function and renal damage, with a decrease in interstitial inflammation. HEH reduced interstitial fibrosis, tubular atrophy, and improved PBR expression.


CONCLUSIONS
This study suggests that cold preservation in HEH has a beneficial action in in vivo renal preservation and reduces tubular necrosis, interstitial inflammation, and fibrosis in these groups. In addition, PBR detection was correlated to the level of preservation integrity.
Hauet
Thierry
T
Département de Génétique Animale, Institut National de Recherche Agronomique, Surgères, Faculté de Médecine (EA 2426), Poitiers, France. thhauet@aol.fr.
Han
Zeqiu
Z
Doucet
Carole
C
Ramella-Virieux
Silvina
S
Hadj Aïssa
Aoumeur
A
Carretier
Michel
M
Papadopoulos
Vassilios
V
D000241:Adenosine; D000493:Allopurinol; D000818:Animals; D005978:Glutathione; D006085:Graft Survival / Q000502:physiology*; D007328:Insulin; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000473:pathology / Q000502:physiology*; D008297:Male; D023421:Models, Animal; D009926:Organ Preservation / Q000379:methods; D019188:Organ Preservation Solutions; D011188:Potassium / Q000032:analysis*; D011887:Raffinose; D015427:Reperfusion Injury / Q000517:prevention & control*; D012964:Sodium / Q000032:analysis*; D013552:Swine; D013997:Time Factors; D014182:Transplantation, Autologous
D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D012964:Sodium; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose; D011188:Potassium