Hernandez A, Light J A, Barhyte D Y, Mabudian M, Gage F
Washington Hospital Center, Transplantation Services, Washington, DC 20010, USA.
Transplantation. 1999 Jan 27;67(2):200-6. doi: 10.1097/00007890-199901270-00003.
The objective of this study was to determine if allopurinol (AL) and/or trifluoperazine (TFP) added to the Belzer machine preservation solution (MPS) improves the function of non-heart-beating donor (NHBD) canine kidneys.
Anesthetized canines underwent bilateral dissection of the renal vessels, obtaining baseline flow. After removing one kidney (heart-beating donor [HBD]), the dog was exsanguinated. After remaining in situ for 120 min (30-min warm ischemia time, 90-min cold ischemia time), the second kidney was removed (NHBD), flushed, biopsied, and weighed. The kidneys were machine-perfused separately for 20 hr, and pressure, flow, and resistance were measured serially. The kidneys were randomly assigned to a perfusate group (G): G1=MPS, G2=MPS+TFP, G3=MPS+AL, and G4=MPS+TFP+AL. Kidneys were implanted separately into a single recipient dog. Flow, resistance, and urine output were measured serially for 4 hr. Blood and urine samples and kidney biopsies were then obtained. All measurements were standardized to 100 g of kidney weight.
HBD kidneys functioned better than NHBD kidneys in all groups, as expected. Although perfusate G1 was the most effective solution for HBD kidneys, the TFP additive (perfusate G2) more effectively reversed the vasospastic effects of ischemia/reperfusion for NHBD than the MPS solution (G1) with or without other additives. In HBD kidneys, the addition of AL resulted in the best creatinine clearance; however, AL was less effective than MPS alone in NHBD kidneys. TFP+AL together were completely ineffective in preserving renal function, regardless of whether the kidneys were from HBD or NHBD.
MPS+TFP more effectively protected renal function against reperfusion injury in the NHBD than MPS alone, AL, or AL+TFP. AL exerts a salutary effect on creatinine clearance in HBD but not in the NHBD. The TFP and AL combination should not be used together with the MPS in machine preservation of kidneys.
本研究的目的是确定添加到Belzer机器保存液（MPS）中的别嘌醇（AL）和/或三氟拉嗪（TFP）是否能改善非心脏跳动供体（NHBD）犬肾的功能。
对麻醉的犬进行双侧肾血管解剖，获取基线流量。切除一侧肾脏（心脏跳动供体[HBD]）后，使犬放血。在原位停留120分钟（30分钟热缺血时间，90分钟冷缺血时间）后，切除另一侧肾脏（NHBD），冲洗、活检并称重。将肾脏分别进行机器灌注20小时，并连续测量压力、流量和阻力。将肾脏随机分配到灌注液组（G）：G1 = MPS，G2 = MPS + TFP，G3 = MPS + AL，G4 = MPS + TFP + AL。将肾脏分别植入同一只受体犬体内。连续4小时测量流量、阻力和尿量。然后采集血液和尿液样本以及肾脏活检组织。所有测量值均按100克肾脏重量进行标准化。
正如预期的那样，所有组中HBD肾脏的功能均优于NHBD肾脏。虽然灌注液G1对HBD肾脏是最有效的溶液，但对于NHBD，TFP添加剂（灌注液G2）比含或不含其他添加剂的MPS溶液（G1）更有效地逆转了缺血/再灌注的血管痉挛效应。在HBD肾脏中，添加AL导致肌酐清除率最佳；然而，在NHBD肾脏中，AL的效果不如单独使用MPS。无论肾脏来自HBD还是NHBD，TFP + AL联合使用在保护肾功能方面完全无效。
与单独使用MPS、AL或AL + TFP相比，MPS + TFP在NHBD中更有效地保护肾功能免受再灌注损伤。AL对HBD的肌酐清除率有有益作用，但对NHBD则不然。在肾脏的机器保存中，TFP和AL组合不应与MPS一起使用。
