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Minimising cold ischaemic injury in an experimental model of kidney transplantation
Author(s) -
Hosgood Sarah A.,
Bagul Atul,
Nicholson Michael L.
Publication year - 2011
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.2010.02396.x
Subject(s) - medicine , creatinine , urology , renal function , transplantation , cold storage , kidney transplantation , kidney , urinary system , acute kidney injury , area under the curve , ex vivo , in vivo , biology , horticulture , microbiology and biotechnology
Eur J Clin Invest 2011; 41 (3): 233–240 Abstract Background Cold ischaemic (CI) injury is associated with reduced renal graft function and survival. However, there is little evidence on the benefits of reducing CI injury within a 24 h period in donation after cardiac death (DCD) kidney transplantation. Methods Porcine kidneys subjected to 10‐min warm ischaemia were retrieved and flushed with hyperosmolar citrate (HOC) preservation solution at 4 °C. They were stored on ice for periods of 2, 6, 18 or 24 h ( n = 6). Renal function and injury were assessed during 3 h of ex‐vivo reperfusion with oxygenated autologous blood. Results Area under the curve (AUC) serum creatinine (Cr) levels were significantly higher in the 18‐ and 24‐h groups and creatinine clearance (CrCl) lower compared to the 2‐h group ( P = 0·001, 0·003). Urinary biomarkers of ischaemic damage (Endothelin‐1, Total nitric oxide) and renal and tubular cell function significantly correlated with the duration of CI time ( r = 0·726, 0·642; P ≤ 0·001). Conclusions This study demonstrated the progressive effects of CI injury in DCD porcine kidneys over a 24 h hypothermic storage period. This highlights the need to minimise the cold storage period to improve graft function in DCD kidney transplantation.