[The viability of kidneys tested by gadolinium-perfusion MRI during ex vivo perfusion].
BACKGROUND
Marginal kidneys must be reanimated before their transplantation. Reanimation is conducted with hypothermic pulsatile perfusion. The tests used generally to demonstrate the viability is the vascular resistance which is not convenient for everybody. We have developed a magnetic resonance compatible perfusional technology allowing us to test the organs during the perfusion by Gd-perfusion MRI.


RESULTS
We have used pigs' kidneys with no warm ischemic time to establish the basis in a normal kidney. After an eight-hour hypothermic pulsatile perfusion, kidneys are submitted to a Gd perfusion. First, we measure the anatomy of the vessels, then the distribution of Gd in the kidney. We obtain simultaneously a dynamic study of the organs where T0 represents the Gd bolus arrival in the cortex and TP the maximum saturation time of Gd.


CONCLUSIONS
We have observed that a normal T0 is inferior to 30s and TP is inferior to one minute. We have compared these values with ATP resynthesis in these organs and found that they correlate. We hope for the future through that predictive use of Gd-MRI to avoid the clinical use of "too" marginal kidneys or the discard of good kidneys but not corresponding with the vascular resistance theory.
Buchs
J-B
JB
Service de chirurgie viscérale et de transplantation, hôpitaux universitaires de Genève, 24, rue Micheli-du-Crest, 1211 Genève 14, Suisse. jean-bernard.buchs@hcuge.ch
Lazeyras
F
F
Bühler
L
L
Vallee
J-P
JP
Nastasi
A
A
Ruttimann
R
R
Morel
P
P
D000818:Animals; D003287:Contrast Media; D007668:Kidney / Q000000981:diagnostic imaging*; D016030:Kidney Transplantation; D008279:Magnetic Resonance Imaging; D008536:Meglumine; D009942:Organometallic Compounds; D011877:Radionuclide Imaging; D013552:Swine; D014022:Tissue Survival
D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine