[Prevention of ischemia before cold ischemia by pharmcologic donor conditioning--experimental findings].
The loop-diuretic piretanide was used to study the influence of pharmacological donor pretreatment on immediate postischemic function in a pig model of kidney transplantation based on the results of a clinical pilot study [4]. Following laparotomy, both kidneys were flushed via a transaortal catheter with Eurocollins-solution and surgically removed. A cold ischemic period of 1 or 24 h was chosen. After that period, kidneys were reperfused with intraoperatively drawn heparinized blood for one hour. We used a special instrument for hemoperfusion of isolated organs which allows perfusion for several hours under steady-state conditions. Four groups were formed: Control and piretanide, 1 or 24 h cold ischemia. The perfusion of piretanide-treated organs resulted in a lower perfusion-resistance, calculated as pressure/flow-ratio or as pressure/glomerular filtrationratio. The flow in the pretreated group was higher, thus excluding a higher shunt-volume. In parallel, oxygen consumption as a parameter of postischemic function start and creatinine clearance were higher in the piretanide treated groups. The experiments demonstrate a superior postischemic function of pretreated kidneys in comparison to control organs after 1 and 24 hours of cold ischemia in this model.
D000818:Animals; D003080:Cold Temperature; D004232:Diuretics / Q000494:pharmacology*; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology; D019194:Ischemic Preconditioning / Q000379:methods*; D007668:Kidney / Q000098:blood supply*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000502:physiology*; D009926:Organ Preservation; D010477:Perfusion; D010865:Pilot Projects; D011292:Premedication; D015427:Reperfusion Injury / Q000503:physiopathology*; D013449:Sulfonamides / Q000494:pharmacology*; D013552:Swine; D014655:Vascular Resistance / Q000187:drug effects / Q000502:physiology
D004232:Diuretics; D013449:Sulfonamides; C015451:piretanide