title: Kidney transplantation after oxygenated machine perfusion preservation with Custodiol-N solution.
abstract: Custodiol-N, a new preservation solution, has been shown particularly suitable for hypothermic machine perfusion preservation (HMP) in isolated porcine kidneys. These preliminary results should be confirmed in an actual transplant model in vivo. Kidney function after 21 h of HMP was studied in an autotransplant model using Landrace pigs (25-30 kg; n = 6 per group). Perfusion was performed with oxygenated perfusate, using either Custodiol-N solution including 50 g/l dextran 40 (CND) or kidney perfusion solution 1 (KPS-1) as gold standard. Viability of the grafts was followed for 1 week after bilateral nephrectomy in the recipient pigs. HMP with CND resulted in less acute tubular injury, evaluated by levels of fatty acid-binding protein and better clearance function during the first 24 h after Tx than with KPS-1 (P < 0.05, resp.). Serum creatinine tended to be lower in the CND group during the whole observation period. Histological tissue scores one week after Tx were similar in both groups. Expression of endothelin-1 as well as of Toll-like receptor 4 15 min after reperfusion was lower in the CND group (P < 0.05), suggesting less endothelial stress response. The data provide first in vivo evidence for the suitability of Custodiol-N as an effective perfusate for renal machine perfusion.
authors.affiliation: Surgical Research Division, University Clinic of Surgery, Bonn, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Minor
authors.affiliation: Clinic of General, Visceral and Transplantation Surgery, University Hospital of Essen, Essen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Paul
authors.affiliation: Surgical Research Division, University Clinic of Surgery, Bonn, Germany.
authors.forename: Patrik
authors.initials: P
authors.lastname: Efferz
authors.affiliation: Department for Pathology, University Hospital of Essen, Essen, Germany.
authors.forename: Jeremias
authors.initials: J
authors.lastname: Wohlschlaeger
authors.affiliation: Institute of Physiological Chemistry, University Hospital Essen, Essen, Germany.
authors.forename: Ursula
authors.initials: U
authors.lastname: Rauen
authors.affiliation: Clinic of General, Visceral and Transplantation Surgery, University Hospital of Essen, Essen, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Gallinat
mesh_terms: D000818:Animals; D002470:Cell Survival; D003404:Creatinine / Q000097:blood; D004195:Disease Models, Animal; D019332:Endothelin-1 / Q000378:metabolism; D004727:Endothelium / Q000473:pathology; D050556:Fatty Acid-Binding Proteins / Q000097:blood; D006085:Graft Survival; D007249:Inflammation; D007668:Kidney / Q000473:pathology; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000295:instrumentation* / Q000379:methods*; D007684:Kidney Tubules / Q000293:injuries; D009392:Nephrectomy; D009926:Organ Preservation / Q000295:instrumentation* / Q000379:methods; D019188:Organ Preservation Solutions; D010100:Oxygen / Q000378:metabolism; D010477:Perfusion / Q000295:instrumentation*; D015424:Reperfusion; D013552:Swine; D051197:Toll-Like Receptor 4 / Q000378:metabolism
chemical_list: C549285:Custodiol-N solution; D019332:Endothelin-1; D050556:Fatty Acid-Binding Proteins; D019188:Organ Preservation Solutions; D051197:Toll-Like Receptor 4; D003404:Creatinine; D010100:Oxygen
keywords: Custodiol-N; kidney; machine perfusion; preservation; solution