Significance of perfusate lactic acidosis in cadaveric renal transplantation.

Thirty-two human cadaver kidneys were assessed by continuous perfusion before transplantation. Altogether, 26 were transplanted. Ten kidneys functioned immediately, of which nine had excellent renal function at three months. Sixteen had delayed onset of function, of these only five had excellent function at three months. There was no difference in warm ischaemic interval between the two groups or in ice storage time. The immediate function group, however, were perfused for twice as long as the delayed function group. The two groups could not be separated on donor history, but they could be precisely separated during perfusion by measuring lactic acidosis and lactic acid dehydrogenase (LDH). The biggest single difference between the groups was in terms of donor preparation.