Open AccessHypothermic reconditioning after cold storage improves postischemic graft function in isolated porcine kidneys
Author(s) -
Koetting Martina,
Frotscher Carolin,
Minor Thomas
Publication year - 2010
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/j.1432-2277.2009.01014.x
Subject(s) - machine perfusion , medicine , perfusion , cold storage , creatinine , urology , transplantation , renal function , kidney , urinary system , kidney transplantation , viaspan , surgery , anesthesia , biology , liver transplantation , horticulture
Summary Delayed graft function still represents a major complication in clinical kidney transplantation. Here we tested the possibility to improve functional outcome of cold stored kidneys a posteriori by short‐term hypothermic machine perfusion immediately prior to reperfusion. A total of 18 kidneys from female German Landrace pigs was flushed with Histidine‐Tryptophan‐Ketoglutarate solution and cold‐stored for 18 h (control). Some grafts were subsequently subjected to 90 min of hypothermic reconditioning by hypothermic machine perfusion with (HR+O 2 ) or without (HR−O 2 ) oxygenation of the perfusate. Early graft function of all kidneys was assessed thereafter by warm reperfusion in vitro ( n = 6, respectively). Renal function upon reperfusion was significantly enhanced by HR+O 2 with more than threefold increase in renal clearances of creatinine and urea. HR+O 2 also led to significantly higher urinary flow rates and abrogated the activation of caspase 3. By contrast, HR−O 2 was far less effective and only resulted in minor differences compared to control. It is derived from the present data that initial graft function can be significantly improved by 2 h of oxygenated machine perfusion after arrival of the preserved organ in the transplantation clinic.