title: Preservation Solution Effluent Osmolality as a Predictor of Initial Kidney Transplant Dysfunction.
abstract: OBJECTIVE
  The aim of this study was to identify new predictors of kidney graft primary dysfunction from results of metabolic, electrolyte composition, and preservation solution effluent osmolality analyses of kidneys from deceased donors.
  
  
  METHODS
  Samples of left renal veins in Custodiol preservation solution (produced by Dr. F. Kohler, Chemie, Bensheim, Germany) from kidney explants and from back table surgical procedures were obtained from 55 deceased donors. We compared metabolic parameters (glucose and lactate levels), electrolyte composition (potassium, sodium, calcium, chlorine), and effluent osmolality of kidney samples from donors whose recipients had satisfactory initial graft function (n = 44) and dysfunction (n = 22). Values are shown as median and interquartile ranges between the 25th and 75th percentiles. We used the Mann-Whitney U test to compare quantitative variables.
  
  
  RESULTS
  Statistically significant differences were observed in effluent osmolality results between kidneys that resulted in satisfactory graft function (median, 85; interquartile range, 65.5-97.1) and those that did not result in satisfactory graft function (median, 103.25; interquartile range, 78.7-125.75) (P = .045). We also observed a trend toward significance in sodium ion levels (P = .073) and lactate levels (P = .09). No statistically significant differences were shown in samples obtained from the back table surgical procedure.
  
  
  CONCLUSIONS
  As a predictor of an initially satisfactory functioning deceased-donor kidney graft, it is possible to use the level of osmolality in Custodiol solution effluent obtained at explant.
authors.affiliation: From the Republican Scientific and Practical Center for Organ and Tissue Transplantation, 9th City Clinical Hospital, Minsk, Belarus.
authors.forename: Denis
authors.initials: D
authors.lastname: Sadovsky
authors.forename: Oleg
authors.initials: O
authors.lastname: Kalachik
authors.forename: Elena
authors.initials: E
authors.lastname: Oganova
authors.forename: Dzmitry
authors.initials: D
authors.lastname: Fedoruk
authors.forename: Eugeny
authors.initials: E
authors.lastname: Kruchenok
authors.forename: Oleg
authors.initials: O
authors.lastname: Rummo
mesh_terms: D000328:Adult; D001926:Brain Death; D005260:Female; D005947:Glucose / Q000009:adverse effects / Q000737:chemistry; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008353:Mannitol / Q000009:adverse effects / Q000737:chemistry; D008875:Middle Aged; D009392:Nephrectomy; D019188:Organ Preservation Solutions / Q000009:adverse effects* / Q000737:chemistry / Q000378:metabolism; D009994:Osmolar Concentration; D011189:Potassium Chloride / Q000009:adverse effects / Q000737:chemistry; D055031:Primary Graft Dysfunction / Q000175:diagnosis / Q000209:etiology*; D011343:Procaine / Q000009:adverse effects / Q000737:chemistry; D012082:Renal Veins / Q000187:drug effects* / Q000378:metabolism; D012307:Risk Factors; D014019:Tissue Donors; D014021:Tissue Preservation / Q000379:methods*
chemical_list: C039984:Bretschneider cardioplegic solution; D019188:Organ Preservation Solutions; D008353:Mannitol; D011343:Procaine; D011189:Potassium Chloride; D005947:Glucose