UW solution for hypothermic machine perfusion of warm ischemic kidneys.
BACKGROUND
Donation of kidneys from non-heart beating donors (NHBD) is increasingly being used to expand the donor pool. Warm ischemic injury of these kidneys suffered at harvest results in DGF at transplantation. In this study, we used hypothermic continuous machine perfusion preservation to mitigate this injury using two available solutions.


METHODS
Dog kidneys (beagles) were exposed to 0, 60, or 75 min of in situ warm ischemia (37 degrees C), followed by 24 to 72 hr preservation by machine perfusion with Belzer MPS solution or the UW-solution (Viaspan). Auto-transplantation was performed with immediate contralateral nephrectomy. Survival and renal function (serum creatinine) were evaluated for up to 10 days posttransplant.


RESULTS
Both solutions were equally effective for 72 hr machine perfusion preservation of dog kidneys giving 100% survival with only minor renal injury. Both solutions were also equally effective for preservation of kidneys exposed to 60 min of warm ischemia. However, only the UW solution gave reliable preservation (86% survival vs. 25% survival) in kidneys exposed to 75 min of warm ischemia and 24 hr machine perfusion.


CONCLUSIONS
UW solution used with continuous hypothermic machine perfusion preservation can rescue canine kidneys from severe warm ischemic injury.
Lindell
Susanne L
SL
Department of Surgery, Division of Transplantation, University of Wisconsin School of Medicine, Madison, WI, USA.
Compagnon
Philippe
P
Mangino
Martin J
MJ
Southard
James H
JH
D000241:Adenosine / Q000494:pharmacology*; D000493:Allopurinol / Q000494:pharmacology*; D000818:Animals; D001831:Body Temperature; D015925:Cryopreservation / Q000379:methods*; D004285:Dogs; D005260:Female; D005978:Glutathione / Q000494:pharmacology*; D006085:Graft Survival; D006323:Heart Arrest / Q000503:physiopathology; D007328:Insulin / Q000494:pharmacology*; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D016030:Kidney Transplantation; D009926:Organ Preservation; D019188:Organ Preservation Solutions / Q000494:pharmacology*; D010477:Perfusion / Q000295:instrumentation*; D011887:Raffinose / Q000494:pharmacology*; D013997:Time Factors
D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose