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Minimising cold ischaemic injury in an experimental model of kidney transplantation.

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.

journal_name

Eur J Clin Invest

journal_title

European journal of clinical investigation

authors

Hosgood SA,Bagul A,Nicholson ML

doi

10.1111/j.1365-2362.2010.02396.x

subject

Has Abstract

pub_date

2011-03-01 00:00:00

pages

233-40

issue

3

eissn

0014-2972

issn

1365-2362

journal_volume

41

pub_type

杂志文章

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