Yoshida Hiroshi, Okuno Hiroshi, Kamoto Toshiyuki, Habuchi Tomonori, Toda Yoshinobu, Hasegawa Seiki, Nakamura Takayuki, Wada Hiromi, Ogawa Osamu, Yamamoto Shingo
Department of Urology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Transplantation. 2002 Nov 15;74(9):1231-6. doi: 10.1097/00007890-200211150-00006.
Previously, we developed a new organ preserving solution, ET-Kyoto solution (ETKS), and showed that it is effective for lung and skin cold storage. Our high sodium-low potassium solution containing trehalose and gluconate is chemically stable at room temperature. In this study, the efficacy of ETKS for renal cold storage compared with Euro-Collins solution (ECS) and University of Wisconsin solution (UWS) was investigated.
A preflush of Krebs-Henseleit buffer was used before cold storage because ECS and UWS, but not ETKS, failed to be distributed thoroughly into each renal segment when directly flushed, as determined by staining with trypan blue. The kidneys were stored at 4 degrees C in each solution after the preflush and were reperfused 24 hr later for 120 min with 37 degrees C Krebs-Henseleit buffer containing albumin. For physiological evaluation, perfusion flow rates, creatinine clearance, and fractional sodium reabsorption were evaluated. Histological examination also was performed to determine tubular, glomerular, and interstitial changes. Moreover, distribution of perfusate at the beginning of reperfusion was assessed by using trypan blue.
The kidneys preserved in ETKS and UWS showed better physiological function and less histological damage than those preserved in ECS. Furthermore, at the beginning of reperfusion using trypan blue, almost all renal segments were stained in the ETKS and UWS groups, whereas they were partially stained in the ECS group.
These results indicate that this simple and chemically stable solution, ETKS, could be a promising substitute for UWS.
此前,我们研发了一种新的器官保存液——ET-京都溶液(ETKS),并证明其对肺和皮肤冷藏有效。我们的含海藻糖和葡萄糖酸盐的高钠低钾溶液在室温下化学性质稳定。在本研究中,我们调查了ETKS与欧洲柯林斯溶液(ECS)和威斯康星大学溶液(UWS)相比用于肾脏冷藏的效果。
冷藏前先用克雷布斯-亨泽莱特缓冲液预冲洗,因为通过台盼蓝染色确定,直接冲洗时ECS和UWS不能充分分布到每个肾段,而ETKS可以。预冲洗后,肾脏在每种溶液中于4℃保存,24小时后用含白蛋白的37℃克雷布斯-亨泽莱特缓冲液再灌注120分钟。为进行生理学评估,评估灌注流速、肌酐清除率和钠重吸收分数。还进行了组织学检查以确定肾小管、肾小球和间质的变化。此外,在再灌注开始时用台盼蓝评估灌注液的分布。
与保存在ECS中的肾脏相比,保存在ETKS和UWS中的肾脏显示出更好的生理功能和更少的组织学损伤。此外,在再灌注开始时使用台盼蓝染色,ETKS组和UWS组几乎所有肾段都被染色,而ECS组只有部分肾段被染色。
这些结果表明,这种简单且化学性质稳定的溶液ETKS有望替代UWS。