Pulsatile perfusion preservation of warm ischaemia-damaged experimental kidney grafts.
BACKGROUND
Cold storage using histidine-tryptophan-ketoglutarate (HTK) solution is used widely in clinical practice for the preservation of warm ischaemia-damaged kidney grafts. This study assessed the efficacy of pulsatile machine perfusion in combination with Polysol for the preservation of warm ischaemia-damaged kidney grafts.


METHODS
After induction of warm ischaemia by clamping of the left renal pedicle for 30 min, pigs were subjected to left nephrectomy. Thereafter, grafts were preserved for 20 h by cold storage with HTK (CS-HTK) or Polysol (CS-PS), or machine preservation with Polysol (MP-PS). Subsequently, contralateral kidneys were removed and preserved kidneys were transplanted. Control pigs underwent unilateral nephrectomy. Renal function was assessed daily for 1 week. Kidney biopsies were analysed for morphology and proliferative response.


RESULTS
Renal function of warm ischaemia-damaged grafts preserved using MP-PS was comparable to that of non-ischaemic controls. MP-PS and CS-PS groups showed improved renal function compared with the CS-HTK group, with more favourable results for MP-PS than for CS-PS. The proliferative response of tubular cells in the CS-HTK group was higher than in all other groups.


CONCLUSIONS
This study demonstrated that the function of warm ischaemia-damaged kidney grafts after pulsatile perfusion preservation was comparable to that of non-ischaemic controls.
Schreinemachers
M C J M
MC
Department of Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Doorschodt
B M
BM
Florquin
S
S
van den Bergh Weerman
M A
MA
Zernecke
A
A
Idu
M M
MM
Tolba
R H
RH
van Gulik
T M
TM
D000818:Animals; D050377:Cold Ischemia / Q000379:methods; D003250:Constriction; D015925:Cryopreservation / Q000379:methods; D005947:Glucose / Q000008:administration & dosage / Q000494:pharmacology; D007150:Immunohistochemistry; D007668:Kidney / Q000033:anatomy & histology / Q000502:physiology*; D016030:Kidney Transplantation / Q000379:methods*; D008353:Mannitol / Q000008:administration & dosage / Q000494:pharmacology; D009926:Organ Preservation / Q000379:methods; D019188:Organ Preservation Solutions / Q000008:administration & dosage / Q000494:pharmacology*; D009929:Organ Size; D011189:Potassium Chloride / Q000008:administration & dosage / Q000494:pharmacology; D011343:Procaine / Q000008:administration & dosage / Q000494:pharmacology; D011673:Pulsatile Flow; D011897:Random Allocation; D051381:Rats; D014182:Transplantation, Autologous; D052096:Warm Ischemia / Q000379:methods*
C039984:Bretschneider cardioplegic solution; D019188:Organ Preservation Solutions; C504758:polysol solution; D008353:Mannitol; D011343:Procaine; D011189:Potassium Chloride; D005947:Glucose