gms | German Medical Science

129. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

24.04. - 27.04.2012, Berlin

Influence of a modified preservation solution in kidney transplantation – a comparative experimental study in a porcine model

Meeting Abstract

  • Hamidreza Fonouni - Chirurgische Univ.-Klinik Heidelberg, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg
  • Mohammad Golriz - Chirurgische Univ.-Klinik Heidelberg, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg
  • Arianeb Mehrabi - Chirurgische Univ.-Klinik Heidelberg, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg
  • Gani Kuttymuratov - Chirurgische Univ.-Klinik Heidelberg, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg
  • Majid EsmaEilzadeh Moghaddam - Chirurgische Univ.-Klinik Heidelberg, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg
  • Thomas Longerich - Univ.-Klinik Heidelberg, Abteilung für Pathologie, Heidelberg
  • Chistian Morath - Univ.-Klinik Heidelberg, Nierenzentrum, Heidelberg
  • Martha Marya Gebhard - Univ.-Klinik Heidelberg, Nierenzentrum, Heidelberg

Deutsche Gesellschaft für Chirurgie. 129. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 24.-27.04.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12dgch144

DOI: 10.3205/12dgch144, URN: urn:nbn:de:0183-12dgch1447

Veröffentlicht: 23. April 2012

© 2012 Fonouni et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: Currently the donor organs are mostly preserved in one of the 2 preservation solutions; UW (solution of the University of Wisconsin) or Custodiol (Bretschneider’s solution, HTK). However, the availability of undamaged donor organs is limited. In consequence, despite of the increasing risk of unsatisfactory results, and due to lack of optimal donors, more marginal organs are transplanted. Therefore, there is a high interest to ameliorate pre-ischemic organ preservation especially for critical donor organs. In this intention, the HTK-N solution (histidine, tryptophane, ketoglutarate new, HTK-N) has been designed and its protective efficacy was compared to the standard preservation solutions UW and standard HTK in experimental kidney transplantations.

Materials and methods: The experiments were performed in pigs according to clinical transplantation procedure. Seventy-six landrace pigs were included into the study, as donors and recipients. The donor kidneys were perfused during explantation with cold UW (n=12), standard HTK (n=14) or HTK-N solutions (n=12), kept ischemically in the respective preservation solution at 4 °C for 30 hours, implanted in the recipient pigs and reperfused. The pigs survived in daily control for 7 days. Thereafter the transplanted kidneys were explanted. The analytical protocol was identical to the monitoring protocol in clinical patients. The serum creatinine and blood urea nitrogen (BUN) were assessed in pre- and post-reperfusion phase, 3rd and 7th day post transplantation. Additionally, tissue samples were taken to analyze the histopathological degree of tubular injury and regeneration before and after reperfusion.

Results: The 3 preservation groups were comparable in age, body weight, and hemodynamic parameters. According to statistical proof they differed in none of the control parameters.

Conclusion: Although the new preservation HTK solution is in several points a well-thought-out modification of the standard HTK solution, its preservation efficacy at least in 30 hours kidney preservation in pigs, seems to be comparable to the current used solutions. A real advantage, however, could be confirmed in clinical settings, where marginal organs may influence the clinical outcome.