Department of Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Br J Surg. 2010 Mar;97(3):349-58. doi: 10.1002/bjs.6879.
Cold storage using histidine-tryptophan-ketoglutarate (HTK) solution is used widely in clinical practice for the preservation of warm ischaemia-damaged kidney grafts. This study assessed the efficacy of pulsatile machine perfusion in combination with Polysol for the preservation of warm ischaemia-damaged kidney grafts.
After induction of warm ischaemia by clamping of the left renal pedicle for 30 min, pigs were subjected to left nephrectomy. Thereafter, grafts were preserved for 20 h by cold storage with HTK (CS-HTK) or Polysol (CS-PS), or machine preservation with Polysol (MP-PS). Subsequently, contralateral kidneys were removed and preserved kidneys were transplanted. Control pigs underwent unilateral nephrectomy. Renal function was assessed daily for 1 week. Kidney biopsies were analysed for morphology and proliferative response.
Renal function of warm ischaemia-damaged grafts preserved using MP-PS was comparable to that of non-ischaemic controls. MP-PS and CS-PS groups showed improved renal function compared with the CS-HTK group, with more favourable results for MP-PS than for CS-PS. The proliferative response of tubular cells in the CS-HTK group was higher than in all other groups.
This study demonstrated that the function of warm ischaemia-damaged kidney grafts after pulsatile perfusion preservation was comparable to that of non-ischaemic controls.
含组氨酸-色氨酸-酮戊二酸（HTK）溶液的冷藏在临床实践中被广泛用于保存温热缺血损伤的肾移植物。本研究评估了脉动机器灌注联合 Polysol 用于保存温热缺血损伤的肾移植物的效果。
通过夹闭左肾蒂 30 分钟诱导温热缺血后，进行左肾切除术。此后，用 HTK（CS-HTK）或 Polysol（CS-PS）进行冷藏保存，或用 Polysol（MP-PS）进行机器保存 20 小时。随后，切除对侧肾脏并移植保存的肾脏。对照猪进行单侧肾切除术。术后第 1 天每天评估肾功能。对肾活检进行形态学和增殖反应分析。
使用 MP-PS 保存的温热缺血损伤移植物的肾功能与非缺血对照相似。MP-PS 和 CS-PS 组的肾功能优于 CS-HTK 组，MP-PS 组的结果优于 CS-PS 组。CS-HTK 组肾小管细胞的增殖反应高于其他所有组。
本研究表明，经脉动灌注保存后温热缺血损伤的肾移植物的功能与非缺血对照相似。
