The Effect of Warm Ischemic Time on Renal Function and Injury in the Isolated Hemoperfused Kidney

The precise effect of warm ischemia on renal allograft function remains unclear and leads to variable warm ischemic time (WIT) limits advocated by transplant programs. This study aims to investigate the relationship between WIT, renal ischemia reperfusion injury, and graft function using a hemoperfu...

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Veröffentlicht in:Transplantation 2008-08, Vol.86 (3), p.445-451
Hauptverfasser: HARPER, Simon J. F, HOSGOOD, Sarah A, WALLER, Helen L, BIN YANG, KAY, Mark D, GONCALVES, Ines, NICHOLSON, Michael L
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Sprache:eng
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Zusammenfassung:The precise effect of warm ischemia on renal allograft function remains unclear and leads to variable warm ischemic time (WIT) limits advocated by transplant programs. This study aims to investigate the relationship between WIT, renal ischemia reperfusion injury, and graft function using a hemoperfused kidney model. Porcine kidneys were perfused with normothermic blood on an isolated organ perfusion system. Kidneys were divided into four groups (n=6) and subjected to 7, 15, 25, and 40 min WIT. Physiological parameters were measured throughout the 6 hr perfusion period. Serum, tissue, and urine samples were analyzed for histological and biochemical markers of ischemia reperfusion injury. Creatinine clearance, urine output, renal hemodynamics, and oxygen consumption deteriorated proportionally with increasing WIT. A significant increase in plasma carbonyl levels during perfusion was seen after 25 and 40 min WIT only. Plasma 8-isoprostane levels were higher after 40 min WIT (2.5+/-1.6) vs. 7, 15, and 25 min WIT (0.65+/-0.43, 0.25+/-0.12, and 0.62+/-0.21, respectively; P
ISSN:0041-1337
1534-6080
DOI:10.1097/TP.0b013e31817fe0cd