title: Impact of normothermic preservation with extracellular type solution containing trehalose on rat kidney grafting from a cardiac death donor.
abstract: BACKGROUND
  The aim of this study was to investigate factors that may improve the condition of a marginal kidney preserved with a normothermic solution following cardiac death (CD) in a model of rat kidney transplantation (RTx).
  
  
  METHODS
  Post-euthanasia, Lewis (LEW) donor rats were left for 1 h in a 23°C room. These critical kidney grafts were preserved in University of Wisconsin (UW), lactate Ringer's (LR), or extracellular-trehalose-Kyoto (ETK) solution, followed by intracellular-trehalose-Kyoto (ITK) solution at 4, 23, or 37°C for another 1 h, and finally transplanted into bilaterally nephrectomized LEW recipient rats (n = 4-6). Grafts of rats surviving to day 14 after RTx were evaluated by histopathological examination. The energy activity of these marginal rat kidneys was measured by high-performance liquid chromatography (HPLC; n = 4 per group) and fluorescence intensity assay (n = 6 per group) after preservation with UW or ETK solutions at each temperature. Finally, the transplanted kidney was assessed by an in vivo luciferase imaging system (n = 2).
  
  
  RESULTS
  Using the 1-h normothermic preservation of post-CD kidneys, five out of six recipients in the ETK group survived until 14 days, in contrast to zero out of six in the UW group (p<0.01). Preservation with ITK rather than ETK at 23°C tended to have an inferior effect on recipient survival (p = 0.12). Energy activities of the fresh donor kidneys decreased in a temperature-dependent manner, while those of post-CD kidneys remained at the lower level. ETK was superior to UW in protecting against edema of the post-CD kidneys at the higher temperature. Luminescence intensity of successful grafts recovered within 1 h, while the intensity of grafts of deceased recipients did not change at 1 h post-reperfusion.
  
  
  CONCLUSIONS
  Normothermic storage with extracellular-type solution containing trehalose might prevent reperfusion injury due to temperature-dependent tissue edema.
authors.affiliation: Laboratory of Small Animal Surgery I, School of Veterinary Medicine, Kitasato University, Aomori, Japan.
authors.forename: Satomi
authors.initials: S
authors.lastname: Iwai
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kikuchi
authors.forename: Naoya
authors.initials: N
authors.lastname: Kasahara
authors.forename: Takumi
authors.initials: T
authors.lastname: Teratani
authors.forename: Takashi
authors.initials: T
authors.lastname: Yokoo
authors.forename: Iwao
authors.initials: I
authors.lastname: Sakonju
authors.forename: Shouzou
authors.initials: S
authors.lastname: Okano
authors.forename: Eiji
authors.initials: E
authors.lastname: Kobayashi
mesh_terms: D000818:Animals; D002851:Chromatography, High Pressure Liquid; D003643:Death; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D019188:Organ Preservation Solutions / Q000737:chemistry*; D009929:Organ Size; D051381:Rats; D011917:Rats, Inbred Lew; D013050:Spectrometry, Fluorescence; D016019:Survival Analysis; D014019:Tissue Donors; D014199:Trehalose / Q000032:analysis*
chemical_list: D019188:Organ Preservation Solutions; D014199:Trehalose