Hermens F H, Kievit J K, Nederstigt A P, Stubenitsky B M, Daemen J H, van Kreel B K, Kootstra G
Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands.
Transpl Int. 1999;12(5):372-7. doi: 10.1007/s001470050242.
The use of non-heartbeating (NHB) donor kidneys has led to the search for new methods of viability-testing. We investigated, in a canine model, the relationship between the filtration of dextran 12, 000 into urine and a certain period of warm ischemic time (WIT) during machine perfusion. Twenty-four canine kidneys were divided into three groups, sustaining 0 min, 30 min or 60 min of WIT. After cooling and flushing, the kidneys were perfused on a perfusion machine for 8 h. Three hundred milligrams of dextran 12,000 was added to the perfusate. In the perfusate, dextran and lactate dehydrogenase (LDH) concentrations were measured. Dextran concentrations were also analysed in urine. Intrarenal vascular resistance (IRR) was calculated from pressure and flow characteristics. The 30WIT group showed a higher dextran excretion rate than the other two groups. IRR and LDH measurements showed lower levels in the ischemic groups compared with the control group. Dextran 12,000 is not suitable as a viability test but does show interesting results regarding the low LDH and IRR levels in the ischemic groups.
非心跳(NHB)供体肾脏的使用促使人们寻找新的活力测试方法。我们在犬类模型中研究了分子量为12,000的葡聚糖滤入尿液与机器灌注期间一定时长的热缺血时间(WIT)之间的关系。将24个犬肾分为三组,分别经历0分钟、30分钟或60分钟的WIT。冷却和冲洗后,将肾脏在灌注机上灌注8小时。向灌注液中加入300毫克分子量为12,000的葡聚糖。测定灌注液中的葡聚糖和乳酸脱氢酶(LDH)浓度。同时分析尿液中的葡聚糖浓度。根据压力和流量特性计算肾内血管阻力(IRR)。30分钟WIT组的葡聚糖排泄率高于其他两组。与对照组相比,缺血组的IRR和LDH测量值较低。分子量为12,000的葡聚糖不适合作为活力测试,但确实在缺血组低LDH和IRR水平方面显示出有趣的结果。