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Optimization of the Hemodynamic of the Kidney and Preservation of Glycocalyx During Kidney Transplantations ‐ A Combination of Fluid Therapy and Low Dose Norepinephrine
Author(s) -
Eriksen Jonathan Kunisch,
Moeslund Niels,
Nielsen Lise Have,
Petersen Jens Aage Kølsen,
Jespersen Bente,
Birn Henrik
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.950.10
Subject(s) - medicine , kidney , urology , dialysis , kidney transplantation , transplantation , pathology , surgery
Background Delayed Graft Function (DGF) is a common complication to kidney‐transplanted patients receiving a kidney from brain dead donors. The present study is designed to evaluate the influence of fluid therapy on kidney function and the preservation of the glycocalyx, during kidney transplantation using kidneys from brain dead donors. Method A porcine prospective randomized animal study is performed. The recipients are randomized to either high volume fluid therapy or individualized goal directed fluid therapy (IGDT). The pigs are also randomized to either no Nor‐epinephrine (NE) or continuous low dose NE‐infusion. Brain death is achieved by inflating a 60cc urinary catheter inserted in the epidural space until the intracranial pressure exceeds the systolic pressure. After 4 hours of brain death the kidneys are perfused with “Bridge to life®” and removed and stored cooled at 4°C for at least 18 hours. The recipients are bilaterally nephrectomised and each gets one kidney. The recipient pigs are observed for 10 hours post‐reperfusion. Blood and urine samples are collected during this observation period. Biopsies are taken from the donor kidneys at baseline and after 3 hours of brain death, and in the recipient immediately after reperfusion and 10 hours post reperfusion. The kidney function will be evaluated using measured GFR (mGFR) and by studying the histology of the kidney using light microscopy. We plan to evaluate the glycocalyx degradation by analyzing blood for Syndecan‐1 and Heparan Sufalte using ELISA. Further to evaluate the histology, the biopsies will be studied in microscope, along with immunofluorescence evaluation of Syndecan‐1 for a semi‐quantitative measurement for glycocalyx. Results As this is an ongoing study no results have yet been obtained. Conclusion We hope to show a significantly better kidney function and glycocalyx preservation in the IGDT group, and even better in the group receiving NE. Support or Funding Information This Study is funded by the Novo Nordic fund.