Preservation of Dog Kidneys by Hypothermic Perfusion with Glucose-Free and Glucose-Rich Perfusates

Abstract

Dog kidneys were perfused for 48 h at 8–10°C with two different perfusion fluids: one fluid rich in glucose, and another in which mannitol was a substitute for glucose. Immediately after reimplantation of the perfused kidneys, contralateral nephrectomy was performed. Kidney function, estimated by serum creatinine, was the same in both groups of animals, and 2 weeks after implantation it was identical to that of dogs with a single normal kidney. In a second series of experiments the renal utilization of glucose and glycogen was studied. Although small amounts of perfusate glucose were metabolized to lactate and CO₂, the results of this study indicate that the kidney is not dependent upon glucose for its metabolic needs in order to retain function during 48 h hypothermic preservation.

Current Insights into the Metabolome during Hypothermic Kidney Perfusion—A Scoping Review

“…In the majority of studies, the perfusate was oxygenated (40/52; 77%), most commonly by using a membrane oxygenator (26/40; 65%) (Table S2). In these studies, a mixture of O 2 and CO 2 [17,[19][20][21][22]25,34,[40][41][42][43][44][45] or a mixture of O 2 , CO 2 , and nitrogen [26,27,38,[46][47][48][49] was given. Surface oxygenation with room air or O 2 (13/40; 33%) [20,32,37,38,[41][42][43][50][51][52][53][54][55] was also used.…”

“…Details are listed in Tables 2 and S8. In nine studies, radioactively labeled metabolites-also called tracers-were added to the perfusion circuit to investigate active metabolic pathways: 14 C-glucose [27,42,[46][47][48], 14 C-mevalonate [53], 14 C-acetate [47], 14 C-lactate [47], 14 C-labeled amino acids ( 14 Ccycloleucine [42], 14 C-leucine [41], 14 C-threonine [41]), 14 C-labeled fatty acids ( 14 C-linoleate [46,48,49], 14 C-palmitate [26,46,48,49], 14 C-caprylate [42,46,48], 14 C-myristic acid [48]).…”

“…A decrease in perfusate glucose and an increase in perfusate lactate concentration was seen during oxygenated perfusion [27,42,[46][47][48]. Only one study showed no change in perfusate glucose level with a low lactate and non-measurable pyruvate during oxygenated perfusion with bovine serum albumin [34].…”

“…Only one study showed no change in perfusate glucose level with a low lactate and non-measurable pyruvate during oxygenated perfusion with bovine serum albumin [34]. This glucose drop was more pronounced when glucose was a component of the perfusate [27] and less pronounced when amino acids [42] or fatty acids [46,47] were added. Interestingly, Slaattelid et al also found a different perfusate glucose uptake and release pattern when glucose was administered intravenously before kidney procurement [27].…”

“…This glucose drop was more pronounced when glucose was a component of the perfusate [27] and less pronounced when amino acids [42] or fatty acids [46,47] were added. Interestingly, Slaattelid et al also found a different perfusate glucose uptake and release pattern when glucose was administered intravenously before kidney procurement [27]. Three studies found a decrease in tissue glucose regardless of whether the perfusion medium was glucose-rich or -poor [27,37,38].…”