[Pharmacological preconditioning with sildenafil of warm ischemic kidneys].
OBJECTIVE
To evaluate the preconditioning effect of sildenafil administered preoperatively in kidneys subjected to a period of warm ischemia (WI), hypothermic perfusion (HP) or cold storage (CS) and finally, autotransplant (AT).


METHODS
We studied 6 groups of autotransplanted kidneys: no-WI-inmediate AT (Group A); 45 min of WI + immediate AT (Group B); 45 min of WI + 60 min of HP + autotransplant (Group C); 45 min of WI + 60 min of CS + autotransplant (Group D); 100 mg of oral sildenafil preoperatively + 45 min of WI + autotransplant (Group E); 100 mg of oral sildenafil preoperatively + 45 min of WI+60 min of HP + autotransplant (Group F). Belzer solution was used for HP; UW-Viaspan for CS. Inmediately after the autotransplant (reperfusion period), we recorded in real time for 60 min the values of Renal vascular Flow (RVF) and Renal Vascular Resistance (RVR). Nitric Oxide levels in the cava and renal graft vein were recorded every 15 min during the 60 min of the reperfusion-study period. Conventional & Electronic microscopy were completed after the process.


RESULTS
We obtained significant higher values of RVF and lower values of RVR in sildenafil groups (E and F) in comparison to the other groups (A-D) (Table 1). NO levels were also significantly higher in groups E and F (Fig. 1). Groups A, B, E and F showed integrity of tubule and endothelium in comparison to groups C and D in the microscopic study.


CONCLUSIONS
We showed a beneficious effect of sildenafil in inmediate post-transplant reperfusion hemodynamic and biochemical parameters of kidneys subjected to a critical period of warm-ischemia.
Lledó García
E
E
Servicios de Urología, Hospital General Universitario Gregorio Marañón, Madrid. ENLLGA@terra.es
Rodríguez Martínez
D
D
Cabello Benavente
R
R
Dulín
Elena
E
García Bordas
J
J
Fernández Alvarez
E
E
Hernández Fernández
C
C
del Cañizo López
J F
JF
D000818:Animals; D019194:Ischemic Preconditioning / Q000379:methods*; D016030:Kidney Transplantation; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use*; D013552:Swine; D052096:Warm Ischemia
D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate