| Kidney transplantation from non-heart-beating donors after oxygenated low-flow machine perfusion preservation with histidine-tryptophan-ketoglutarate solution. | |
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MedLine Citation:
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PMID: 15717215 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Thomas Minor; Mario Sitzia; Frank Dombrowski |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't Date: 2004-11-25 |
Journal Detail:
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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:
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Created Date: 2005-02-17 Completed Date: 2005-07-19 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8908516 Medline TA: Transpl Int Country: Germany |
Other Details:
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Languages: eng Pagination: 707-12 Citation Subset: IM |
Affiliation:
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Surgical Research Division, University of Bonn, Sigmund Freud Strasse 25, 53127, Bonn, Germany. tminor@uni-bonn.de |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine
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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:
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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
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