title: A comparison of hypothermic machine perfusion versus static cold storage in an experimental model of renal ischemia reperfusion injury.
abstract: BACKGROUND
  There is increasing support for the use of hypothermic machine perfusion (HMP) in an attempt to reduce preservation injury. However, experimental evidence is needed to further examine the effects of HMP on renal ischemia reperfusion injury.
  
  
  METHODS
  Porcine kidneys were subjected to 10 min of warm ischemia followed by 18 hr of static cold storage with hyperosomolar citrate (HOC), histidine-tryptophan-ketoglutarate (HTK), or University of Wisconsin (UW) solutions or 18 hr HMP with Kidney Perfusion Solution using the Lifeport perfusion system. Renal function, oxidative damage, and morphology were assessed during 3 hr of reperfusion with autologous blood using an isolated organ perfusion system.
  
  
  RESULTS
  During reperfusion, intrarenal resistance was significantly lower in the HMP group compared with HOC and UW (area under the curve; HMP 3.8+/-1.7, HOC 9.1+/-4.3, UW 7.7+/-2.2, HTK 5.6+/-1.9 mm Hg/min; P=0.006), and creatinine clearance was significantly higher compared with the UW group (area under the curve creatinine clearance; HMP 9.8+/-7.3, HOC 2.2+/-1.7, UW 1.8+/-1.0, HTK 2.1+/-1.8 mL/min/100 g; P=0.004). Tubular function was significantly improved in the HMP group (P<0.05); however, levels of lipid peroxidation were significantly higher (P=0.005).
  
  
  CONCLUSIONS
  HMP demonstrated a reduced level of preservation injury compared with the static techniques resulting in improved renal and tubular function and less tubular cell inflammation during reperfusion.
authors.affiliation: Department of Infection, Immunity and Inflammation, Transplant Group, University of Leicester, Leicester General Hospital, Leicester, UK.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Hosgood
authors.forename: Bin
authors.initials: B
authors.lastname: Yang
authors.forename: Atul
authors.initials: A
authors.lastname: Bagul
authors.forename: Ismail H
authors.initials: IH
authors.lastname: Mohamed
authors.forename: Michael L
authors.initials: ML
authors.lastname: Nicholson
mesh_terms: D000136:Acid-Base Equilibrium / Q000187:drug effects; D000241:Adenosine / Q000494:pharmacology; D000493:Allopurinol / Q000494:pharmacology; D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002951:Citrates / Q000494:pharmacology; D050377:Cold Ischemia / Q000009:adverse effects / Q000295:instrumentation*; D003404:Creatinine / Q000097:blood; D004195:Disease Models, Animal; D004867:Equipment Design; D005947:Glucose / Q000494:pharmacology; D005978:Glutathione / Q000494:pharmacology; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000295:instrumentation*; D007328:Insulin / Q000494:pharmacology; D007668:Kidney / Q000098:blood supply / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects; D007770:L-Lactate Dehydrogenase / Q000097:blood; D015227:Lipid Peroxidation / Q000187:drug effects; D008353:Mannitol / Q000494:pharmacology; D019188:Organ Preservation Solutions / Q000494:pharmacology*; D018384:Oxidative Stress / Q000187:drug effects; D010477:Perfusion / Q000009:adverse effects / Q000295:instrumentation*; D009195:Peroxidase / Q000378:metabolism; D011189:Potassium Chloride / Q000494:pharmacology; D011343:Procaine / Q000494:pharmacology; D011887:Raffinose / Q000494:pharmacology; D015427:Reperfusion Injury / Q000209:etiology / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control*; D013552:Swine; D013997:Time Factors
chemical_list: D015415:Biomarkers; C039984:Bretschneider cardioplegic solution; D002951:Citrates; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D008353:Mannitol; D011343:Procaine; D000493:Allopurinol; D011189:Potassium Chloride; D003404:Creatinine; D007770:L-Lactate Dehydrogenase; D009195:Peroxidase; D001219:Aspartate Aminotransferases; D005978:Glutathione; D005947:Glucose; D000241:Adenosine; D011887:Raffinose