Nicholson Michael L, Hosgood Sarah A, Metcalfe Matthew S, Waller Julian R, Brook Nicholas R
Division of Transplant Surgery, University of Leicester, Leicester General Hospital, Leicester, United Kingdom.
Transplantation. 2004 Aug 15;78(3):333-7. doi: 10.1097/01.tp.0000128634.03233.15.
Pulsatile machine perfusion offers theoretical advantages as a method of preserving kidneys before transplantation. This may be particularly the case for organs taken from non-heart-beating donors (NHBD), but there is still a lack of data to support this view. The aim of this study was to compare the effectiveness of static cold storage in ice (CS) and hypothermic pulsatile machine perfusion (MP) as methods of renal transplant preservation.
Groups of large white pigs (n=5) underwent left nephrectomy after warm ischemic times (WIT) of 0 or 30 min. Kidneys were preserved by CS or by cold (3degrees-8degreesC) MP for 24 hr. The left kidney was then autotransplanted into the right iliac fossa and an immediate right nephrectomy was performed. Renal function was assessed daily for 14 days.
Fourteen-day animal survival rates for 0 and 30 min WIT were four of five and one of five after both CS and MP. In the zero WIT groups, there was improved recovery of renal function after MP (area under the creatinine curve, 4,722+/-2,496 [MP] vs. 8,849+/-2,379 [CS]; P<0.05). MP did not improve renal function after 30 min of WIT (mean daily area under the creatinine curve, 1,077+/-145 [MP] vs. 1,049+/-265 [CS]).
In this model, MP improved 24-hr preservation of kidneys not subjected to warm ischemia (heart-beating donor model), but there was no evidence that MP was a better method of preservation than CS for kidneys exposed to 30 min of WIT (NHBD model).
搏动性机器灌注作为一种肾脏移植前的保存方法具有理论优势。对于来自非心脏骤停供体（NHBD）的器官而言可能尤其如此，但仍缺乏数据支持这一观点。本研究的目的是比较冰浴静态冷藏（CS）和低温搏动性机器灌注（MP）作为肾脏移植保存方法的有效性。
将大型白色猪分组（n = 5），在0或30分钟的热缺血时间（WIT）后进行左肾切除术。肾脏通过CS或冷（3℃-8℃）MP保存24小时。然后将左肾自体移植到右髂窝，并立即进行右肾切除术。连续14天每天评估肾功能。
在CS和MP后，0分钟和30分钟WIT的14天动物存活率分别为五分之四和五分之一。在0分钟WIT组中，MP后肾功能恢复有所改善（肌酐曲线下面积，4,722±2,496 [MP] 对比 8,849±2,379 [CS]；P<0.05）。30分钟WIT后MP并未改善肾功能（肌酐曲线下平均每日面积，1,077±145 [MP] 对比 1,049±265 [CS]）。
在该模型中，MP改善了未经历热缺血的肾脏（心脏骤停供体模型）的24小时保存效果，但没有证据表明对于经历30分钟WIT的肾脏（NHBD模型），MP是比CS更好的保存方法。
