Laboratory of Small Animal Surgery I, School of Veterinary Medicine, Kitasato University, Aomori, Japan.
PLoS One. 2012;7(3):e33157. doi: 10.1371/journal.pone.0033157. Epub 2012 Mar 21.
The aim of this study was to investigate factors that may improve the condition of a marginal kidney preserved with a normothermic solution following cardiac death (CD) in a model of rat kidney transplantation (RTx).
Post-euthanasia, Lewis (LEW) donor rats were left for 1 h in a 23°C room. These critical kidney grafts were preserved in University of Wisconsin (UW), lactate Ringer's (LR), or extracellular-trehalose-Kyoto (ETK) solution, followed by intracellular-trehalose-Kyoto (ITK) solution at 4, 23, or 37°C for another 1 h, and finally transplanted into bilaterally nephrectomized LEW recipient rats (n = 4-6). Grafts of rats surviving to day 14 after RTx were evaluated by histopathological examination. The energy activity of these marginal rat kidneys was measured by high-performance liquid chromatography (HPLC; n = 4 per group) and fluorescence intensity assay (n = 6 per group) after preservation with UW or ETK solutions at each temperature. Finally, the transplanted kidney was assessed by an in vivo luciferase imaging system (n = 2).
Using the 1-h normothermic preservation of post-CD kidneys, five out of six recipients in the ETK group survived until 14 days, in contrast to zero out of six in the UW group (p<0.01). Preservation with ITK rather than ETK at 23°C tended to have an inferior effect on recipient survival (p = 0.12). Energy activities of the fresh donor kidneys decreased in a temperature-dependent manner, while those of post-CD kidneys remained at the lower level. ETK was superior to UW in protecting against edema of the post-CD kidneys at the higher temperature. Luminescence intensity of successful grafts recovered within 1 h, while the intensity of grafts of deceased recipients did not change at 1 h post-reperfusion.
Normothermic storage with extracellular-type solution containing trehalose might prevent reperfusion injury due to temperature-dependent tissue edema.
本研究旨在探讨在心脏死亡（CD）后使用常温溶液保存边缘肾脏的条件，以改善大鼠肾移植（RTx）模型中边缘肾脏的状况。
在 23°C 的房间中，对安乐死后的 Lewis（LEW）供体大鼠进行 1 小时的处理。这些临界肾脏移植物在威斯康星大学（UW）、乳酸林格氏液（LR）或细胞外海藻糖-京都（ETK）溶液中保存，然后在 4°C、23°C 或 37°C 下再保存 1 小时，最后移植到双侧肾切除的 LEW 受体大鼠中（n=4-6）。通过组织病理学检查评估 RTx 后存活至第 14 天的移植物。使用高效液相色谱法（HPLC；每组 n=4）和荧光强度测定法（每组 n=6）测量 UW 或 ETK 溶液在每种温度下保存后这些边缘大鼠肾脏的能量活性。最后，通过体内荧光素成像系统评估移植肾（n=2）。
在 1 小时常温保存 CD 后肾脏的情况下，ETK 组 6 个受体中有 5 个存活至第 14 天，而 UW 组 6 个受体中没有 1 个存活（p<0.01）。在 23°C 下使用 ITK 而不是 ETK 保存时，对受体存活的效果较差（p=0.12）。新鲜供体肾脏的能量活性呈温度依赖性降低，而 CD 后肾脏的能量活性保持在较低水平。与 UW 相比，ETK 能更好地保护 CD 后肾脏在较高温度下免受水肿的影响。成功移植的荧光强度在 1 小时内恢复，而死亡受体的移植强度在再灌注后 1 小时内没有变化。
含海藻糖的细胞外型溶液常温保存可能会防止因温度依赖性组织水肿引起的再灌注损伤。
