Evaluating the effects of extended cold ischemia on interstitial metabolite in grafts in kidney transplantation using microdialysis.
OBJECTIVE
During kidney transplantation (KTx), the length of cold ischemia time (CIT) and the subsequent changes in energy metabolism may lead to variations in interstitial metabolites. Using microdialysis (MD), we evaluated the effects of a short and long CIT on changes of these metabolites.


METHODS
Sixteen pigs were randomized in two identical groups, one with a short CIT and the other one with a long CIT. Using MD in the transplanted grafts, we evaluated the parenchyma concentrations of glucose, lactate, pyruvate, glutamate and glycerol in different stages.


RESULTS
We noted that during the warm ischemia time (WIT) and in the early post-reperfusion phase glucose levels increased more significantly in the long CIT group and remained high until the end of monitoring. At the end of CIT and during WIT, the long CIT group had a significantly higher glycerol level, but the level dropped gradually in the late post-reperfusion phase and reached a steady state in both groups.


CONCLUSIONS
The extended CIT clearly results in considerably impaired graft metabolism. The high interstitial glucose levels within hours after KTx could be considered as a marker of primary delayed function of the graft. Furthermore, the glycerol value could reflect the extent of graft injury during the ischemia time or in case of acute impairment of graft perfusion.
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Hamidreza
H
Fonouni
Parvin
P
Jarahian
Morva Tahmasbi
MT
Rad
Mohammad
M
Golriz
Alireza
A
Faridar
Majid
M
Esmaeilzadeh
Mohammadreza
M
Hafezi
Stephan
S
Macher-Goeppinger
Thomas
T
Longerich
Berk
B
Orakcioglu
Oliver W
OW
Sakowitz
Camelia
C
Garoussi
Arianeb
A
Mehrabi
D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D050377:Cold Ischemia; D004734:Energy Metabolism / Q000502:physiology*; D018698:Glutamic Acid / Q000378:metabolism; D005990:Glycerol / Q000378:metabolism; D006085:Graft Survival / Q000502:physiology; D007668:Kidney / Q000098:blood supply* / Q000503:physiopathology*; D016030:Kidney Transplantation / Q000379:methods*; D019344:Lactic Acid / Q000378:metabolism; D017551:Microdialysis / Q000379:methods*; D019289:Pyruvic Acid / Q000378:metabolism; D013552:Swine; D052096:Warm Ischemia
D001786:Blood Glucose; D019344:Lactic Acid; D018698:Glutamic Acid; D019289:Pyruvic Acid; D005990:Glycerol