AIM: Transplantations of kidneys from non-heart-beating donors (NHBD) are intended to increase the donor pool by 20% to 30%. Nevertheless the rate of primary nonfunction and delayed graft function is generally higher among this group of donors. The goal of this study was to assess whether kidney preservation by a pulsatile perfusion machine was able to limit the renal lesions due to ischemia reperfusion injuries as compared with static incubation. We have used a model of an autotransplanted kidney exposed to controlled warm ischemia in the pig to mimic the clinical conditions of NHBD. MATERIAL AND METHODS: Left kidneys from 11 large white pigs aged 4 weeks were harvested after vascular clamping of the renal vessels for 1 hour. Kidneys were preserved for 22 hours. Two groups were studied: the MPS static group (static incubation with Belzer MPS; n = 6) versus the MPS RM group (renal perfusion with Belzer MPS; n = 5). Kidneys were then autotransplanted into pigs after a right nephrectomy. The primary end point was animal survival rate at 1 month. Secondary endpoints were evolution of the plasma creatinine values, proteinuria, tubular sodium reabsorption, and histological features at 1 month. RESULTS: For all biological parameters, the differences between the perfusion and the static incubation groups were significant, except creatinine, with favorable effects for the perfusion machine group. The histological data at 1 month showed recovery of the normal kidney architecture in the MPS RM group. CONCLUSION: In our pig experimental model that reproduced the clinical conditions of a NHBD, we demonstrated better kidney preservation when the pulsatile perfusion machine was used as compared with static conservation.
AIM: Transplantations of kidneys from non-heart-beating donors (NHBD) are intended to increase the donor pool by 20% to 30%. Nevertheless the rate of primary nonfunction and delayed graft function is generally higher among this group of donors. The goal of this study was to assess whether kidney preservation by a pulsatile perfusion machine was able to limit the renal lesions due to ischemia reperfusion injuries as compared with static incubation. We have used a model of an autotransplanted kidney exposed to controlled warm ischemia in the pig to mimic the clinical conditions of NHBD. MATERIAL AND METHODS: Left kidneys from 11 large whitepigs aged 4 weeks were harvested after vascular clamping of the renal vessels for 1 hour. Kidneys were preserved for 22 hours. Two groups were studied: the MPS static group (static incubation with Belzer MPS; n = 6) versus the MPS RM group (renal perfusion with Belzer MPS; n = 5). Kidneys were then autotransplanted into pigs after a right nephrectomy. The primary end point was animal survival rate at 1 month. Secondary endpoints were evolution of the plasma creatinine values, proteinuria, tubular sodium reabsorption, and histological features at 1 month. RESULTS: For all biological parameters, the differences between the perfusion and the static incubation groups were significant, except creatinine, with favorable effects for the perfusion machine group. The histological data at 1 month showed recovery of the normal kidney architecture in the MPS RM group. CONCLUSION: In our pig experimental model that reproduced the clinical conditions of a NHBD, we demonstrated better kidney preservation when the pulsatile perfusion machine was used as compared with static conservation.