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      Pulsatile perfusion preservation of warm ischaemia-damaged experimental kidney grafts.

      The British Journal of Surgery

      Animals, Cold Ischemia, methods, Constriction, Cryopreservation, Glucose, administration & dosage, pharmacology, Immunohistochemistry, Kidney, anatomy & histology, physiology, Kidney Transplantation, Mannitol, Organ Preservation, Organ Preservation Solutions, Organ Size, Potassium Chloride, Procaine, Pulsatile Flow, Random Allocation, Rats, Transplantation, Autologous, Warm Ischemia

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          Cold storage using histidine-tryptophan-ketoglutarate (HTK) solution is used widely in clinical practice for the preservation of warm ischaemia-damaged kidney grafts. This study assessed the efficacy of pulsatile machine perfusion in combination with Polysol for the preservation of warm ischaemia-damaged kidney grafts. After induction of warm ischaemia by clamping of the left renal pedicle for 30 min, pigs were subjected to left nephrectomy. Thereafter, grafts were preserved for 20 h by cold storage with HTK (CS-HTK) or Polysol (CS-PS), or machine preservation with Polysol (MP-PS). Subsequently, contralateral kidneys were removed and preserved kidneys were transplanted. Control pigs underwent unilateral nephrectomy. Renal function was assessed daily for 1 week. Kidney biopsies were analysed for morphology and proliferative response. Renal function of warm ischaemia-damaged grafts preserved using MP-PS was comparable to that of non-ischaemic controls. MP-PS and CS-PS groups showed improved renal function compared with the CS-HTK group, with more favourable results for MP-PS than for CS-PS. The proliferative response of tubular cells in the CS-HTK group was higher than in all other groups. This study demonstrated that the function of warm ischaemia-damaged kidney grafts after pulsatile perfusion preservation was comparable to that of non-ischaemic controls. (c) 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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