J F McAnulty1. 1. Department of Surgical Sciences, University of Wisconsin, Madison, USA.
Abstract
OBJECTIVE: To describe the effect of hypothermic storage on transplanted feline kidneys. STUDY DESIGN: Kidneys were stored in University of Wisconsin (UW) sodium gluconate (n = 3) or phosphate-buffered sucrose (n = 5) solutions before transplantation. ANIMAL POPULATION: Eight cats with renal failure and seven normal cats as kidney donors. METHODS: Kidneys were perfused through the renal artery with cold (10 degree C) storage solution and immersed in the solution on ice until transplantation. RESULTS: Mean ex vivo storage time was 4.8 +/- 0.36 hours (range, 3.5 to 7 hours). Seven recipient cats survived surgery. Five of the cats had decreased serum creatinine concentrations from a mean of 8.2 mg/dL (range, 4.0 to 15.8 mg/dL) preoperatively to 1.7 mg/dL (range 1.3 to 2.2 mg/dL) within 4 days of surgery. In one cat, serum creatinine concentration dropped from 15.1 to 3.7 mg/dL in 3 days, but the cat developed a ureteral stricture that required revision. One graft did not function, and the cat died on day 19. The mean postoperative survival time of cats that were discharged from the hospital (n = 6) was 254 days (range, 49 to 717 days) at the time of this report. Long-term renal function (> 60 days postoperatively; n = 5) was excellent with mean serum creatinine concentrations of 1.6 +/- 0.15 mg/dL. CONCLUSIONS: Hypothermic storage is feasible for short-term preservation of feline kidneys. The maximal length of feasible storage remains unknown. CLINICAL RELEVANCE: Hypothermia protects against ischemia-induced nephron loss during ex vivo manipulation of the allograft and allows longer safe vascular anastomosis times. Short-term hypothermic storage also provides time to accommodate modifications in scheduling or anesthetic management of the recipient operation.
OBJECTIVE: To describe the effect of hypothermic storage on transplanted feline kidneys. STUDY DESIGN: Kidneys were stored in University of Wisconsin (UW) sodium gluconate (n = 3) or phosphate-buffered sucrose (n = 5) solutions before transplantation. ANIMAL POPULATION: Eight cats with renal failure and seven normal cats as kidney donors. METHODS: Kidneys were perfused through the renal artery with cold (10 degree C) storage solution and immersed in the solution on ice until transplantation. RESULTS: Mean ex vivo storage time was 4.8 +/- 0.36 hours (range, 3.5 to 7 hours). Seven recipient cats survived surgery. Five of the cats had decreased serum creatinine concentrations from a mean of 8.2 mg/dL (range, 4.0 to 15.8 mg/dL) preoperatively to 1.7 mg/dL (range 1.3 to 2.2 mg/dL) within 4 days of surgery. In one cat, serum creatinine concentration dropped from 15.1 to 3.7 mg/dL in 3 days, but the cat developed a ureteral stricture that required revision. One graft did not function, and the cat died on day 19. The mean postoperative survival time of cats that were discharged from the hospital (n = 6) was 254 days (range, 49 to 717 days) at the time of this report. Long-term renal function (> 60 days postoperatively; n = 5) was excellent with mean serum creatinine concentrations of 1.6 +/- 0.15 mg/dL. CONCLUSIONS:Hypothermic storage is feasible for short-term preservation of feline kidneys. The maximal length of feasible storage remains unknown. CLINICAL RELEVANCE: Hypothermia protects against ischemia-induced nephron loss during ex vivo manipulation of the allograft and allows longer safe vascular anastomosis times. Short-term hypothermic storage also provides time to accommodate modifications in scheduling or anesthetic management of the recipient operation.