Ludwig A, Isemer F E, Kallerhoff M, Rumpf K W
Abteilung Kieferchirurgie, Universität Göttingen.
Langenbecks Arch Chir. 1995;380(2):82-9. doi: 10.1007/BF00186413.
Investigations of changes in activity of renin and blood pressure after reperfusion of the kidney transplant using HTK solution were carried out by means of an autologous, heterotopic model of kidney transplantation applied to dogs. Duration of cold ischemia was 48 h. According to variations in the composition of the HTK perfusion solution three test groups were set up. During the first 20 min after recirculation in each test group the renal venous and arterial renin activities were measured. Parallel to renin activity, the arterial blood pressure was recorded. During the first few minutes following recirculation of the kidney transplant the renin levels in the venous blood of the kidney were higher in test group 1 (HTK solution, perfusion height 120 cm) than in either of the other two, showing a median maximal increase of 195 ng/ml.h. In test group 2 the maximal venous renin concentration fell to 145 ng/ml.h, while graphs take a more uniform course. Test group 3 (HTK/tryptophan) differed from the others in having further improved renin values. After the 7.5 min of observation normal venous renin concentrations were measured following earlier values for maximal increase between 23.1 ng/ml.h and 120 ng/ml.h (median 61.5 ng/ml.h). The best reperfusion of the kidney was observed in the tryptophan group, albeit without any recognizable positive effects on the other renal functions. Initially low renin values do not necessarily correlate with a smooth postoperative renal function and vice versa. Initial renin values cannot provide a secure basis for predicting instant as well as long-term postoperative functions.(ABSTRACT TRUNCATED AT 250 WORDS)
采用犬自体异位肾移植模型,对使用HTK液进行肾移植再灌注后肾素活性及血压变化进行了研究。冷缺血时间为48小时。根据HTK灌注液成分的不同设置了三个试验组。在每个试验组再灌注后的最初20分钟内,测定肾静脉和动脉的肾素活性。与肾素活性同时,记录动脉血压。肾移植再灌注后的最初几分钟内,试验组1(HTK液,灌注高度120 cm)肾静脉血中的肾素水平高于其他两组,最大中位数升高为195 ng/ml·h。试验组2的最大静脉肾素浓度降至145 ng/ml·h,曲线较为平缓。试验组3(HTK/色氨酸)的肾素值进一步改善,与其他组不同。观察7.5分钟后,静脉肾素浓度恢复正常,此前最大升高值在23.1 ng/ml·h至120 ng/ml·h之间(中位数61.5 ng/ml·h)。色氨酸组观察到最佳的肾再灌注情况,尽管对其他肾功能没有明显的积极影响。最初肾素值低并不一定与术后肾功能平稳相关,反之亦然。初始肾素值不能为预测即刻及长期术后功能提供可靠依据。(摘要截短于250字)