Using Tandem Scanning Confocal Microscopy to Predict the Status of Donor Kidneys

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Abstract

Tandem scanning confocal microscopy (TSCM) is a noninvasive form of vital microscopy that can be used to evaluate superficial uriniferous tubules in living kidneys. Because TSCM has a number of advantages over conventional microscopic examination of renal biopsies, the present study was undertaken to determine whether the histopathological images obtained by TSCM correlate with post-transplant renal function. The kidneys of New Zealand male rabbits were harvested, flushed with Euro-Collins solution, and stored at 0–2°C for periods of 24, 48, 67 and 72 h prior to transplantation. TSCM observation of the kidneys prior to their transplantation revealed characteristic histopathological changes of the superficial proximal convoluted tubules that correlated closely with subsequent post-transplant renal function. These observations indicate that TSCM may be of significant value in evaluating the status of donor kidneys prior to their transplantation.

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Cryopreservation of the Mammalian Kidney. I. Transplantation of Rabbit Kidneys Perfused with EC and RPS-2 at 2-4°C

Bijan S Khirabadi, Gregory M Fahy (1994)

The requirements of organ cryopreservation differ from those of conventional organ preservation. The encouraging results of Karow's group with dog kidneys transplanted after perfusion with more than 4 M dimethyl sulfoxide were based on an RPS-2 (renal preservation solution 2) vehicle solution, but transplantation of rabbit kidneys after perfusion with RPS-2 has not been reported. We evaluated RPS-2 in comparison to Euro-Collins solution (EC) using a modified technique for rabbit kidney autotransplantation and a computer-based organ perfusion machine designed for the introduction and removal of cryoprotective agents. Consistent success in rabbit kidney transplantation was found to depend on the anesthetic used, the hydration volumes administered, and direct ureter-to-ureter anastomosis. RPS-2 was found to be equivalent to EC for short-term (about 5 h) preservation by either perfusion or simple cold storage. However, good results with EC were associated with perfusion at 4 degrees C, recovery being significantly worse at 2 degrees C. In addition, we found that the solitary rabbit kidney is not able to fully compensate for the loss of the contralateral kidney, the result being persistent (to 3 weeks) mild elevation of serum creatinine, potassium, and calcium and persistent moderate reduction of serum phosphate. These results establish perfusates, perfusion conditions, transplantation techniques, computer-based perfusion control techniques, and a general clinical baseline that are permissive of further direct experiments on cryoprotectant introduction and removal.