Influence of a modified preservation solution in kidney transplantation: A comparative experimental study in a porcine model.
OBJECTIVE
Currently, due to lack of optimal donors, more marginal organs are transplanted. Therefore, there is a high interest to ameliorate preischemic organ preservation, especially for critical donor organs. In this regard, a new histidine-tryptophane ketoglutarate (HTK-N) solution has been designed and its protective efficacy was compared with the standard preservation solutions-University of Wisconsin solution and standard HTK or Custodiol (Bretschneider's solution).


METHODS
Seventy-two landrace pigs were included into the study, as donors and recipients. The donor kidneys were perfused during explantation with cold University of Wisconsin solution (n = 12), standard HTK (n = 12), or HTK-N solutions (n = 12), kept in the respective preservation solution at 4°C for 30 hours, implanted in the recipient pigs, and reperfused. The pigs survived in daily control for 7 days. The serum creatinine and blood urea nitrogen were assessed in pre- and postreperfusion phase on the 3rdday and 7thday posttransplantation. Additionally, tissue samples were taken to analyze the histopathological degree of tubular injury and regeneration before and after reperfusion.


RESULTS
The three preservation groups were comparable in age, body weight, and hemodynamic parameters. According to statistical proof, they differed in none of the control parameters.


CONCLUSIONS
Although the new preservation HTK solution is in several points a well-thought-out modification of the standard HTK solution, its preservation efficacy, at least for kidney preservation in a pig model for 30 hours, seems to be comparable to the current used solutions. A real advantage, however, could be confirmed in clinical settings, where marginal organs may influence the clinical outcome.
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Mohammad
M
Golriz
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Hamidreza
H
Fonouni
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Gani
G
Kuttymuratov
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Majid
M
Esmaeilzadeh
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Morva Tahmasbi
MT
Rad
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Parvin
P
Jarahian
Department of Pathology, University of Heidelberg, Heidelberg, Germany.
Thomas
T
Longerich
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Alireza
A
Faridar
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Sepehr
S
Abbasi
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany. Electronic address: arianeb_mehrabi@med.uni-heidelberg.de.
Arianeb
A
Mehrabi
Department of Experimental Surgery, University of Heidelberg, Heidelberg, Germany.
Marta M
MM
Gebhard
D000241:Adenosine / Q000494:pharmacology; D000493:Allopurinol / Q000494:pharmacology; D000818:Animals; D001707:Biopsy, Needle; D004195:Disease Models, Animal; D005260:Female; D005947:Glucose / Q000494:pharmacology; D005978:Glutathione / Q000494:pharmacology; D006084:Graft Rejection; D006085:Graft Survival; D007150:Immunohistochemistry; D007328:Insulin / Q000494:pharmacology; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008353:Mannitol / Q000494:pharmacology; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions / Q000737:chemistry* / Q000494:pharmacology; D011189:Potassium Chloride / Q000494:pharmacology; D011343:Procaine / Q000494:pharmacology; D011887:Raffinose / Q000494:pharmacology; D011897:Random Allocation; D012680:Sensitivity and Specificity; D015996:Survival Rate; D013552:Swine; D016896:Treatment Outcome
C039984:Bretschneider cardioplegic solution; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D008353:Mannitol; D011343:Procaine; D000493:Allopurinol; D011189:Potassium Chloride; D005978:Glutathione; D005947:Glucose; D000241:Adenosine; D011887:Raffinose
ischemia reperfusion injury; kidney transplantation; preservation solution