Department of Surgery, Division of Transplantation
Analytical, Diagnostic and Therapeutic Techniques and Equipment | Genetic Phenomena | Nephrology | Pathological Conditions, Signs and Symptoms | Surgery
In this study we evaluated whether gradual rewarming after the period of cold ischemia would improve organ quality in an Isolated Perfused Kidney Model. Left rat kidneys were statically cold stored in University of Wisconsin solution for 24 hours at 4 degrees C. After cold storage kidneys were rewarmed in one of three ways: perfusion at body temperature (38 degrees C), or rewarmed gradually from 10 degrees C to 38 degrees C with stabilization at 10 degrees C for 30 min and rewarmed gradually from 10 degrees C to 38 degrees C with stabilization at 25 degrees C for 30 min. In the gradual rewarming groups the pressure was increased stepwise to 40 mmHg at 10 degrees C and 70 mmHg at 25 degrees C to counteract for vasodilatation leading to low perfusate flows. Renal function parameters and injury biomarkers were measured in perfusate and urine samples. Increases in injury biomarkers such as aspartate transaminase and lactate dehydrogenase in the perfusate were lower in the gradual rewarming groups versus the control group. Sodium re-absorption was improved in the gradual rewarming groups and reached significance in the 25 degrees C group after ninety minutes of perfusion. HSP-70, ICAM-1, VCAM-1 mRNA expressions were decreased in the 10 degrees C and 25 degrees C groups. Based on the data kidneys that underwent gradual rewarming suffered less renal parenchymal, tubular injury and showed better endothelial preservation. Renal function improved in the gradual rewarming groups versus the control group.
Kidneys, Reperfusion, Reperfusion injury, Body temperature, Perfusion, Gene expression, Ischemia, Renal transplantation
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Copyright: © 2015 Mahboub et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
DOI of Published Version
PLoS One. 2015 Dec 2;10(12):e0143859. doi: 10.1371/journal.pone.0143859. eCollection 2015. Link to article on publisher's site
Mahboub, Paria; Ottens, Petra; Seelen, Marc; 't Hart, Nils; Van Goor, Harry; Ploeg, Rutger; Martins, Paulo N.A.; and Leuvenink, Henri, "Gradual Rewarming with Gradual Increase in Pressure during Machine Perfusion after Cold Static Preservation Reduces Kidney Ischemia Reperfusion Injury" (2015). Surgery Publications and Presentations. 155.
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