Effects of arterial pressure in an experimental isolated haemoperfused porcine kidney preservation system |
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Authors: | Hosgood S Harper S Kay M Bagul A Waller H Nicholson M L |
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Affiliation: | Department of Cardiovascular Sciences, Transplant Group, University of Leicester, Leicester General Hospital, Leicester, UK. |
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Abstract: | BACKGROUND: Normothermic preservation provides metabolic support to an ischaemically damaged organ before use as a kidney transplant. Optimal conditions for ex vivo preservation have not yet been established. This study examined the effects of arterial pressure on renal preservation using isolated haemoperfused kidneys. METHODS: An isolated organ preservation system, developed using cardiopulmonary bypass technology, was used to perfuse porcine kidneys with normothermic oxygenated blood. Groups of kidneys (n = 6) were perfused at a mean arterial pressure of 95, 75 or 55 mmHg. RESULTS: Kidneys perfused at the higher mean arterial pressures of 95 and 75 mmHg demonstrated improved renal function: mean(s.d.) area under the curve (AUC) for creatinine clearance 71(19) and 55(30) respectively versus 14(12) in the 55-mmHg group, P = 0.002; AUC for serum creatinine 938(140) and 1290(394) versus 2404(595), P = 0.003. The higher perfusion pressures were also associated with better acid-base homeostasis and improved renal haemodynamics. CONCLUSION: Mean arterial pressures of either 95 or 75 mmHg were capable of sustaining physiological renal function, but kidneys in the 95-mmHg group demonstrated superior renal function overall. |
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