Background
Restoring meta
bolism to an organ after hypothermic storage and
before transplantation could reverse some of the detrimental effects of i
schemic injury. This may
be particularly
beneficial for kidneys from non-heart-
beating (NHBD) donors that sustain significant periods of warm and cold i
schemic injury. This pilot study assessed the feasi
bility of a short period of normothermic preservation (NP) in a porcine autotransplant model.
Methods
Kidneys were subjected to 30 min of warm ischemia, then preserved by hypothermic machine perfusion (HMP) for 22 h or 20 h HMP followed by 2 h of NP using autologous blood. Kidneys were then re-implanted, a contralateral nephrectomy performed, and renal function measured over 10 d.
Results
Post-transplant, 4/6 animals survived in the?NP group compared with 5/6 in the HMP group (P?= 1.00). Creatinine levels fell below 250 ¦Ìmol/L in all four of the surviving animals in the NP group compared with 2/5 in the HMP group (P = 0.608). There was no difference in levels of renal function (peak creatinine, HMP= 1736 ¡À 866 versus NP =1553 ¡À 516 ¦Ìmol/L; P ?0.990). Levels of lipid peroxidation were significantly lower 60 min post-transplant in the NP group (NP = 477 ¡À 118.0 versus HMP = 671 ¡À 99.4 pg/mL; P?=?0.026).
Conclusion
A period of NP at the end of the renal preservation period in NHB kidneys is a feasible method of kidney preservation. NP could prove to be a useful technique to predetermine graft function and allow pre-transplant modification of organs.