低温肾脏保存对离体灌注肾脏的影响：再灌注方法的比较。

Effects of hypothermic kidney preservation on the isolated perfused kidney: a comparison of reperfusion methods.

作者信息

Rice M J, Southard J H, Hoffmann R M, Belzer F O

出版信息

Cryobiology. 1985 Apr;22(2):161-7. doi: 10.1016/0011-2240(85)90170-1.

Abstract

Two isolated-perfused kidney methods were used to study the effects of hypothermic preservation on renal function in dog kidneys. The isolated-machine-perfused kidney (IMPK) used an in vitro perfusion technique--the perfusate was a Krebs-bicarbonate type delivered to the kidney at 37 degrees C by a mechanical pump at a constant pressure (100 mm Hg). The isolated-blood-perfused kidney (IBPK) utilized transplantation of the preserved kidney to the femoral vasculature. Renal function (urine analysis) was determined over a 1-hr reperfusion interval and included GFR (creatinine clearance), urine formation, and Na+ reabsorption. Kidneys preserved for only 24 hr by cold storage in either Collins'--C3 solution or in hypotonic citrate and kidneys hypothermically perfused for 24 hr demonstrated greater retention of renal function when reperfused by blood (IBPK) than with the in vitro perfusate (IMPK). The GFR was reduced by 38-58% when tested with the IBPK, but by 80-90% when tested with the IMPK. Na+ reabsorption was normal (97%) with blood reperfusion but was reduced to 36-50% in cold-stored kidneys and 82% in hypothermically perfused kidneys determined by machine reperfusion (IMPK). However, kidneys perfused for 72 hr demonstrated more similar renal functions when tested by either IMPK or IBPK. GFR was reduced to 20% (IBPK) and 11% (IMPK) and Na+ reabsorption averaged 76-85% (IBPK or IMPK). These results suggest that either reperfusion method is suitable for determining the effects of renal preservation on kidney function in kidneys preserved for 72 hr but, for short-term preserved kidneys (24 hr), the IBPK model may be preferred.

摘要

采用两种离体灌注肾方法研究低温保存对犬肾肾功能的影响。离体机械灌注肾（IMPK）采用体外灌注技术——灌注液为 Krebs - 碳酸氢盐型，由机械泵在 37℃以恒定压力（100 mmHg）输送至肾脏。离体血液灌注肾（IBPK）则是将保存的肾脏移植到股血管系统。在 1 小时的再灌注期间测定肾功能（尿液分析），包括肾小球滤过率（肌酐清除率）、尿液生成和钠重吸收。仅在 Collins' - C3 溶液或低渗柠檬酸盐中冷藏保存 24 小时的肾脏以及低温灌注 24 小时的肾脏，经血液再灌注（IBPK）时比经体外灌注液（IMPK）再灌注时表现出更好的肾功能保留。用 IBPK 检测时肾小球滤过率降低 38 - 58%，而用 IMPK 检测时降低 80 - 90%。血液再灌注时钠重吸收正常（97%），但通过机器再灌注（IMPK）测定，冷藏保存的肾脏中钠重吸收降至 36 - 50%，低温灌注的肾脏中降至 82%。然而，灌注 72 小时的肾脏在用 IMPK 或 IBPK 检测时表现出更相似的肾功能。肾小球滤过率降至 20%（IBPK）和 11%（IMPK），钠重吸收平均为 76 - 85%（IBPK 或 IMPK）。这些结果表明，对于保存 72 小时的肾脏，两种再灌注方法都适用于确定肾脏保存对肾功能的影响，但对于短期保存（24 小时）的肾脏，IBPK 模型可能更可取。