Characterization of improved renal transplant preservation mechanisms using PB-2 flush solution by HPLC assay

Renal flush solutions have been found to be beneficial for extending organ viability, but their mechanisms of action are poorly understood. In order to delineate these mechanisms we studied the addition of mannitol and adenosine to a modified simple hypothermic intracellular flush solution (PB-2), and the relationships of renal adenine nucleotide (AN) concentrations with ischemia, reperfusion and viability. A significant (P < 0.05) and progressive decay in AN and increase in total degradation products (DP; hypoxanthine and xanthine) was noted during warm ischemia. Total AN and AMP were significantly higher after 50 h of cold storage in the PB-2 compared to the C-2 control cold flush group. Viability was associated with a significant (P < 0.01) regeneration of AN within 45 min of reperfusion. HPLC assay indicated that PB-2 cold flush solution enhances renal viability by both diminution of reperfusion injury enabling better reflow and primary preservation of AN. The latter process may appreciably contribute to the former process.