Document Detail


Kidney transplantation from non-heart-beating donors after oxygenated low-flow machine perfusion preservation with histidine-tryptophan-ketoglutarate solution.
MedLine Citation:
PMID:  15717215     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to determine the potential benefit of aerobic machine preservation (MP) with non-colloidal histidine-tryptophan-ketoglutarate (HTK) solution compared with MP with Belzer machine perfusion solution (MPS) and standard cold storage, after marginal kidneys had been obtained from non-heart-beating donors. Cardiac arrest was electrically induced in anaesthetized German landrace pigs (20-25 kg bw). Their kidneys were harvested 40 min thereafter, flushed with HTK by gravity of 100 cm H2O via the renal artery and then stored in HTK for 18 h at 4 degrees C. Other organs were subjected to oxygenated (pO2>500 mmHg) hypothermic pulsatile low-flow machine perfusion with HTK or MP with Belzer MPS at P(max)=40 mmHg, yielding transrenal flow values of 0.2-0.3 ml/min per g with HTK and approximately twice that amount with Belzer MPS. A well-preserved vascular endothelium and intact tubular epithelium were documented by electron microscopy at the end of perfusion preservation in both solutions as well as after cold storage. Concentrations of ATP (in micromoles per gramme) in tissue homogenates at the end of perfusion preservation with HTK were 1.18+/-0.12 vs 0.16+/-0.02 (P<0.05) after simple cold storage and 2.43+/-0.23 after perfusion with Belzer MPS, thus documenting a relevant effect of low-flow perfusion on tissue oxygenation. Viability of the grafts was followed for 1 week after heterotopic transplantation and bilateral nephrectomy in the recipient pigs. Machine perfusion with HTK significantly improved cortical microcirculation upon early reperfusion in vivo, as well as maximal serum levels of urea and creatinine, compared to recipients receiving cold-stored grafts. No differences could be found between MP with HTK or Belzer MPS. In conclusion, provision of oxygen during storage is possible by low-flow perfusion with HTK as with Belzer MPS and apparently improves graft viability after transplantation.
Authors:
Thomas Minor; Mario Sitzia; Frank Dombrowski
Related Documents :
2406975 - Postoperative surveillance of infrainguinal bypass.
10191705 - The importance of graft blood flow and peripheral outflow resistance for early patency ...
1370735 - Different aprotinin applications influencing hemostatic changes in orthotopic liver tra...
1425825 - Variations of magnesium, iron, copper and zinc during the colonic wound healing process...
2258945 - Traumatic brain injury creates biphasic systemic hemodynamic and organ blood flow respo...
21402425 - Orientation and detachment dynamics of bacillus spores from stainless steel under contr...
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2004-11-25
Journal Detail:
Title:  Transplant international : official journal of the European Society for Organ Transplantation     Volume:  17     ISSN:  0934-0874     ISO Abbreviation:  Transpl. Int.     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-02-17     Completed Date:  2005-07-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8908516     Medline TA:  Transpl Int     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  707-12     Citation Subset:  IM    
Affiliation:
Surgical Research Division, University of Bonn, Sigmund Freud Strasse 25, 53127, Bonn, Germany. tminor@uni-bonn.de
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adenosine / pharmacology
Adenosine Triphosphate / metabolism
Allopurinol / pharmacology
Animals
Endothelium, Vascular / ultrastructure
Glucose / pharmacology*
Glutathione / pharmacology
Heart Arrest*
Insulin / pharmacology
Kidney / blood supply,  metabolism
Kidney Transplantation*
Mannitol / pharmacology*
Microcirculation / drug effects
Microscopy, Electron
Organ Preservation / methods*
Organ Preservation Solutions / pharmacology*
Oxygen
Oxygenators*
Partial Pressure
Perfusion / instrumentation,  methods*
Potassium Chloride / pharmacology*
Procaine / pharmacology*
Raffinose / pharmacology
Renal Circulation / drug effects
Swine
Tissue Donors*
Chemical
Reg. No./Substance:
0/Bretschneider cardioplegic solution; 0/Organ Preservation Solutions; 0/University of Wisconsin-lactobionate solution; 11061-68-0/Insulin; 315-30-0/Allopurinol; 50-99-7/Glucose; 512-69-6/Raffinose; 56-65-5/Adenosine Triphosphate; 58-61-7/Adenosine; 59-46-1/Procaine; 69-65-8/Mannitol; 70-18-8/Glutathione; 7447-40-7/Potassium Chloride; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Intraoperative blood transfusion requirement is the main determinant of early surgical re-interventi...
Next Document:  Isoniazid-related fulminant hepatic failure in a child: assessment of the native liver's early regen...