UW solution for hypothermic machine perfusion of warm ischemic kidneys

Area of Science:

• Transplantation immunology
• Organ preservation techniques
• Nephrology

Background:

• Kidney donation from non-heart beating donors (NHBD) is crucial for expanding donor availability.
• Warm ischemic injury during organ procurement leads to delayed graft function (DGF) in NHBD kidneys.
• Hypothermic continuous machine perfusion preservation is explored to mitigate warm ischemic injury.

Purpose of the Study:

• To evaluate the efficacy of hypothermic machine perfusion using two preservation solutions (Belzer MPS and UW-solution) in mitigating warm ischemic injury in canine kidneys.
• To compare the protective effects of Belzer MPS and UW-solution on kidney function and survival after varying durations of warm ischemia.

Main Methods:

• Canine kidneys underwent 0, 60, or 75 minutes of in situ warm ischemia.
• Kidneys were preserved for 24-72 hours using hypothermic machine perfusion with either Belzer MPS or UW-solution.
• Auto-transplantation followed by contralateral nephrectomy, with renal function assessed via serum creatinine levels for 10 days.

Main Results:

• Both Belzer MPS and UW-solution provided 100% survival with minimal injury for 72-hour preservation and 60 minutes of warm ischemia.
• For kidneys subjected to 75 minutes of warm ischemia and 24-hour perfusion, UW-solution demonstrated superior preservation (86% survival) compared to Belzer MPS (25% survival).

Conclusions:

• UW-solution, when used with continuous hypothermic machine perfusion, can effectively rescue canine kidneys from significant warm ischemic injury.
• This preservation strategy holds promise for improving outcomes in kidney transplantation from NHBDs.