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Canine kidney preservation by pulsatile and nonpulsatile perfusion
ABSTRACTS-ELEVENTH
570
measured parameters to remain closest to normal physiological values were then used to preserve rabbit kidneys by hypothermic perfusion at 5”C, using standard techniques already described. Subsequent function of the preserved kidneys was measured by autografting with immediate contraIatera1 nephrectomy and the results compared with those obtained with a illhurnin/dextral1 perfusate. 102. Evidence of Abnormal Pas.$ive Reubsorj)tion in Hypothermic Perfused Canine Kidney:j. A. SMALL,* H. T. BELL,* K. W. SELL (U.S. Naval
Institute,
R. S. FILO,"
AND
Medical Research Bethesda, Maryland 20014).
The possibiIity of abnormal back-diffusion of inulin and p-amino-hippurate (PAN) in hypothermic perfused kidneys, suggested by previous studies, was investigated using the technique of retrograde intraureteral injection (RII) in canine kidneys perfused at 15°C with cryoprecipitated pIasma. The RI1 was performed by injecting 4-6 ml of a retrograde injection solution (MS) containing ‘H-in&n, PAW, and ‘“C-dextran into the ureter. After a 3-n& period of ureteral occlusion, the RIS was recollected in I-ml serial samples. The degree of back-diffusion of inulin and PAH was assessed from their recoveries relative to destram When RI1 was performed in vivo (pentobarbital-anesthetized dogs), the recoveries of inulin and PAH were identical to destran recovery. However, in perfused kidneys, recoveries of inulin and PAH fell to 85 and 70%, respectively, of the simultaneous dextran recovery. Venous eAluent perfusate collected during RI1 was found to contain the following percentages of the injected amounts of the marker substances; d&ran, 9.2%; in&n, 11%; and PAH, 22%. These results represent strong evidence that hypothermic perfused kidneys allow passive diffusion of inulin and PAII out of tubules, leading to erroneously low clearance values for these substances. (Supported by the U.S. Navy Bureau of Medicine and Surgery, Research Task No. 4102.0015 A2GC.) 103. Canine Kidney Preservation by Pulsatib and Nonpukatile Perfusion. R. GRUNJJMANN,” E. MEUSEL,* M. RAAB,* AND K. PKHLMAIISR (Chirurg. Universit&klinik, D-5 Kiiln 4, Josef-Stefzmann-Strig, Germany). Introduced by D. E. Pegg. Thirty-six perfused in 48 hr and was used in
dog kidneys under hypothermia were pairs pulsatile resp. nonpulsatile for then transplanted. Human albumin the perfusion fluid. During preserva-
.4NNUAL
MEETING
tion, samples were taken at regular intervals from the perfusate and the sodium and potassium concentration, o>molality, dextrose, protein, lactate, and pyruvate, and the release of enzymes were measured. After transplantation the immediate function of the kidneys was controlled by PAWand inulin clearances. Additionally, in a second group pulsatile and nonpulsatile perfused kidneys were injected with silicone rubber after 12, 48, and 72 hr preservation time to visualize the intr;lrenal distribution of flow. Kidneys subjected to either type of perfusion did not difl’er significantly with respect to their perfusion behavior (enzyme release, edema formation, metabolism) nor in their function after transplantation. In both groups there was the same pattern of intrarenal flow distribution with a higher Aowrate in the renal cortex after I;2 than 48 or 72 hr preservation time. That nonpulsatile perfusion is equivalent to pulsatiIe perfusion, may he concluded. 104. The Effect of Pulsatik Flow on the presercation of Rabbit Kidneys by Hypothermic Perftkon at 5°C. C. J. GREEN,* D, E:. PEG& A. L. DOCXETT," AND M. C. WnsmMAN (Animal Division and Division of Cryobiology, Clinical Research Centre, Harrow, England). Rabbit kidneys were perfused at 5°C using a synthetic perfusnte containing an extracellular balance of ions, dextran T70 and bovine serum albumin. After preservation for 24 hr, the kidneys were autografted and the contralateral kidney removed. Two experimental groups were studied: In one, the perfusion pressure was kept constant at 30 mm Hg, while in the other group, a pulse pressure of approximately 30 mm Hg was provided, but the root mean square (rms ) equivalent of the cannula pressure was also 40 mm Hg. The circuits were identical in all respects except for the presence of a silicone rubber finger in the bubble trap of the pulsating circuit; the finger was connected to a hydraulic cylinder which reciprocated at 60 strokes/min. The rms equivalent of the can&a pressure was determined by ff;eding the pressure transducer signa into an analogue rms module (Philbrick Nexus No. 4352) thn output of which was used to control the pedusion pump. Perfusate flow rate (and hence vascular resistance) ancl kidney weight were monitored continuously, and the function of the transplanted kidneys was measured by estimating blood urea and serum creatinine levels at 2-3 day intervals, and by the histological appearances of the kidneys at death or sacrifice of the animals. Comparison
570
measured parameters to remain closest to normal physiological values were then used to preserve rabbit kidneys by hypothermic perfusion at 5”C, using standard techniques already described. Subsequent function of the preserved kidneys was measured by autografting with immediate contraIatera1 nephrectomy and the results compared with those obtained with a illhurnin/dextral1 perfusate. 102. Evidence of Abnormal Pas.$ive Reubsorj)tion in Hypothermic Perfused Canine Kidney:j. A. SMALL,* H. T. BELL,* K. W. SELL (U.S. Naval
Institute,
R. S. FILO,"
AND
Medical Research Bethesda, Maryland 20014).
The possibiIity of abnormal back-diffusion of inulin and p-amino-hippurate (PAN) in hypothermic perfused kidneys, suggested by previous studies, was investigated using the technique of retrograde intraureteral injection (RII) in canine kidneys perfused at 15°C with cryoprecipitated pIasma. The RI1 was performed by injecting 4-6 ml of a retrograde injection solution (MS) containing ‘H-in&n, PAW, and ‘“C-dextran into the ureter. After a 3-n& period of ureteral occlusion, the RIS was recollected in I-ml serial samples. The degree of back-diffusion of inulin and PAH was assessed from their recoveries relative to destram When RI1 was performed in vivo (pentobarbital-anesthetized dogs), the recoveries of inulin and PAH were identical to destran recovery. However, in perfused kidneys, recoveries of inulin and PAH fell to 85 and 70%, respectively, of the simultaneous dextran recovery. Venous eAluent perfusate collected during RI1 was found to contain the following percentages of the injected amounts of the marker substances; d&ran, 9.2%; in&n, 11%; and PAH, 22%. These results represent strong evidence that hypothermic perfused kidneys allow passive diffusion of inulin and PAII out of tubules, leading to erroneously low clearance values for these substances. (Supported by the U.S. Navy Bureau of Medicine and Surgery, Research Task No. 4102.0015 A2GC.) 103. Canine Kidney Preservation by Pulsatib and Nonpukatile Perfusion. R. GRUNJJMANN,” E. MEUSEL,* M. RAAB,* AND K. PKHLMAIISR (Chirurg. Universit&klinik, D-5 Kiiln 4, Josef-Stefzmann-Strig, Germany). Introduced by D. E. Pegg. Thirty-six perfused in 48 hr and was used in
dog kidneys under hypothermia were pairs pulsatile resp. nonpulsatile for then transplanted. Human albumin the perfusion fluid. During preserva-
.4NNUAL
MEETING
tion, samples were taken at regular intervals from the perfusate and the sodium and potassium concentration, o>molality, dextrose, protein, lactate, and pyruvate, and the release of enzymes were measured. After transplantation the immediate function of the kidneys was controlled by PAWand inulin clearances. Additionally, in a second group pulsatile and nonpulsatile perfused kidneys were injected with silicone rubber after 12, 48, and 72 hr preservation time to visualize the intr;lrenal distribution of flow. Kidneys subjected to either type of perfusion did not difl’er significantly with respect to their perfusion behavior (enzyme release, edema formation, metabolism) nor in their function after transplantation. In both groups there was the same pattern of intrarenal flow distribution with a higher Aowrate in the renal cortex after I;2 than 48 or 72 hr preservation time. That nonpulsatile perfusion is equivalent to pulsatiIe perfusion, may he concluded. 104. The Effect of Pulsatik Flow on the presercation of Rabbit Kidneys by Hypothermic Perftkon at 5°C. C. J. GREEN,* D, E:. PEG& A. L. DOCXETT," AND M. C. WnsmMAN (Animal Division and Division of Cryobiology, Clinical Research Centre, Harrow, England). Rabbit kidneys were perfused at 5°C using a synthetic perfusnte containing an extracellular balance of ions, dextran T70 and bovine serum albumin. After preservation for 24 hr, the kidneys were autografted and the contralateral kidney removed. Two experimental groups were studied: In one, the perfusion pressure was kept constant at 30 mm Hg, while in the other group, a pulse pressure of approximately 30 mm Hg was provided, but the root mean square (rms ) equivalent of the cannula pressure was also 40 mm Hg. The circuits were identical in all respects except for the presence of a silicone rubber finger in the bubble trap of the pulsating circuit; the finger was connected to a hydraulic cylinder which reciprocated at 60 strokes/min. The rms equivalent of the can&a pressure was determined by ff;eding the pressure transducer signa into an analogue rms module (Philbrick Nexus No. 4352) thn output of which was used to control the pedusion pump. Perfusate flow rate (and hence vascular resistance) ancl kidney weight were monitored continuously, and the function of the transplanted kidneys was measured by estimating blood urea and serum creatinine levels at 2-3 day intervals, and by the histological appearances of the kidneys at death or sacrifice of the animals. Comparison