Renal cortical levels of adenosine triphosphate: restoration after prolonged ischemia by in situ perfusion of ATP-MgCl2.

The metabolic consequences of low-temperature kidney preservation by pulsatile perfusion and cold storage were evaluated in canine kidneys by serial adenosine triphosphate (ATP) determinations. Serial cortical ATP levels were determined (1) after optimal harvest, (2) after 60 minutes of warm ischemia, and (3) after 60 minutes of warm ischemia followed by an intra-aortic infusion of ATP-MgCl2. After 24 hours of preservation, cortical ATP levels were significantly greater when pulsatile perfusion was used-both after optimal harvest and after 60 minutes of warm ischemia. Cortical ATP levels were significantly greater at 24 hours in both perfused and cold-storage kidneys when an intra-aortic infusion of ATP-MgCl2 was used following ischemia. These results may explain the 24-hour limitation of cold storage as well as its inferior results following ischemia injury. Furthermore, since ATP is critical in cellular metabolism, the technique of intra-aortic ATP-MgCl2 infusion warrants further investigation in the field of organ preservation.