title: Hypothermic machine perfusion after static cold storage does not improve the preservation condition in an experimental porcine kidney model.
abstract: BACKGROUND
  Combining hypothermic techniques, as a more practical approach to preservation, may enhance the condition of kidneys donated after cardiac death.
  
  
  METHODS
  Porcine kidneys were retrieved after 10 min in situ warm ischaemia, then preserved by either 18 h static cold storage (CS), hypothermic machine perfusion for 18 h (HMP) or 14 h static CS followed by 4 h HMP (4HMP). Kidneys were reperfused for 3 h with oxygenated autologous blood on an isolated organ perfusion system to assess renal function and injury.
  
  
  RESULTS
  Intrarenal resistance was significantly higher in the 4HMP group than in the CS and HMP groups: mean(s.d.) area under the curve (AUC) 8·48(2·97), 3·41(1·80) and 3·78(1·68) mmHg/min.h respectively (P = 0·011). Creatinine clearance was lower after 4HMP and CS: AUC 2·3(0·6) and 2·2(1·7) ml per min per 100g.h respectively versus 9·8(7·3) ml per min per 100g.h in the HMP group (P = 0·022). Levels of endothelin 1 were higher in the 4HMP and CS groups: mean(s.d.) 21·6(4·0) and 24·2(2·3) pg/ml respectively versus 11·4(4·6) pg/ml in the HMP group (P = 0·002). Morphological damage was increased in the 4HMP group.
  
  
  CONCLUSIONS
  This porcine kidney study demonstrated no advantage to the addition of 4 h of HMP after CS.
authors.affiliation: Department of Infection, Immunity and Inflammation, Transplant Group, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK. sarahhosgood@hotmail.com
authors.forename: S A
authors.initials: SA
authors.lastname: Hosgood
authors.forename: I H
authors.initials: IH
authors.lastname: Mohamed
authors.forename: A
authors.initials: A
authors.lastname: Bagul
authors.forename: M L
authors.initials: ML
authors.lastname: Nicholson
mesh_terms: D000818:Animals; D015925:Cryopreservation / Q000379:methods*; D019332:Endothelin-1 / Q000652:urine; D004797:Enzyme-Linked Immunosorbent Assay; D005919:Glomerular Filtration Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology; D015850:Interleukin-6 / Q000652:urine; D028421:Isoprostanes / Q000652:urine; D007668:Kidney / Q000098:blood supply / Q000166:cytology / Q000503:physiopathology; D016030:Kidney Transplantation; D010477:Perfusion / Q000379:methods*; D009195:Peroxidase / Q000378:metabolism; D015424:Reperfusion; D013552:Swine; D009927:Tissue and Organ Procurement
chemical_list: D019332:Endothelin-1; D015850:Interleukin-6; D028421:Isoprostanes; D009195:Peroxidase