Function and metabolism of canine kidneys after aerobic ischemia by retrograde persufflation with gaseous oxygen

Abstract

Summary. I~etrograde persufflation of isehemie kidneys of dogs via the renal vein with gaseous 02 was evaluated as a method of kidney preservation (retrograde aerobic isehemia) and compared to conventional ischemic storage without additional measures (anaerobic isehemia). Renal preservation in situ lasted 4 hrs at 6°C. A eontralateral nephreetomy was performed before the preservation period. For retrograde aerobic isehemia the persufflation pressure was 30 mm Hg, the gas flowed off via opened capsular vessels.While dogs which had undergone renal anaerobic ischemia showed a marked temporary post-ischemic increase in renal blood flow and in the systemic blood pressure, dogs submitted to renal retrograde aerobic ischemia did not exhibit a storage induced loss of the renal vascular autoregulation. During and after retrograde aerobic isehemia the renal tissue levels of ATP, ADP, and AMP remained within normal ranges; ATP and the sum of adenine nucleotides decreased markedly during anaerobic isehemia. In both the groups a normal renal function was resumed again; but the recovery time of various parameters of renal function (clearance from inulin and PAH, urea excretion, serum concentrations of urea and creatinine) was shorter after retrograde aerobic isehemia than after anaerobic isehemia. Kidneys subjected to retrograde aerobic ischemia exhibited a better functional adaption to the contralateral nephreetomy during the 3 weeks of post-ischemic observation than kidneys stored in anaerobic isehemia. Key words: Renal preservation --Anaerobic ischemia --Aerobic ischemia --Retrograde renal 03 persufflation --Post-ischemic renal function.In search for new approaches to renal preservation, ischemie kidneys were persuffluted with humidified gaseous oxygen. According to biochemical parameters an O3 persufflation via the arteria or vena renalis * Supported by a grant from the Deutsche Forschungsgemeinschaft in the ,,Sonderforschungsbereieh 68". 3*

Persufflation (or gaseous oxygen perfusion) as a method of organ preservation

“…In the first set of experiments, hearts from medium-sized dogs were cannulated at the coronary ostia, flushed with pre-oxygenated normal saline, then persufflated with humidified gaseous carbogen (a mixture of 95% O 2 and 5% CO 2 ). This approach, generally termed anterograde PSF (A-PSF), contrasts with retrograde PSF (R-PSF) which would be tried in the heart [8; 87] and subsequently in the kidney [28; 32]. Hearts maintained at 37°C continued to beat for an average duration of 5.1 hours (2.5–8 hours, range).…”

“…Isselhard and his collaborators published a series of studies that examined the differences between A-PSF and R-PSF [28; 29; 30; 31; 32; 77], which is PSF by delivering the gas in the direction opposite to physiologic flow (starting at the venous end). Historically, the technique of R-PSF also involved the introduction of small, pin-pricks into the surface of the organ – to facilitate gas efflux as illustrated in Figure 1.…”

“…Further studies by this group remained focused on the important differences between A-PSF and R-PSF, by assessing their effects on renal bioenergetic status and function after reperfusion [29; 32]. In situ A-PSF (at 90–100 mmHg) was performed on canine kidneys for 4 hours at 6°C.…”

“…The relative merits of R-PSF versus A-PSF were not clearly established by earlier studies and it was not until the early 1970s that studies were undertaken to directly compare the two methods in a single system (canine kidney) [28; 29; 32]. Isselhard et al developed an in situ ischemia model to study the effects of SCS, A-PSF or R-PSF on canine kidney preservation.…”

Retrograde Oxygen Persufflation of Kidney – Experiment on an Animal

“…Warm ischemia is especially found in NHBD. The procedures for renal graft preservation and recondition applied at individual clinics often differ (4)(5)(6)(7)(8).…”