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Steps for the Autologous Ex vivo Perfused Porcine Liver-kidney Experiment
Published on: December 18, 2013
Leucocyte depletion improves renal function during reperfusion using an experimental isolated haemoperfused organ
1Department of Cardiovascular Sciences, Transplant Group, Leicester General Hospital, Leicester LE5 4PW, UK.
Background:
Leucocytes have been implicated as mediators of renal ischaemia-reperfusion injury. This study aimed to demonstrate the effect of white cells in early renal reperfusion injury using an isolated haemoperfused porcine kidney model.
Methods:
After 2 h cold storage, porcine kidneys were perfused with normothermic autologous blood using an isolated organ preservation system. This was designed using cardiopulmonary bypass technology, and perfusion commenced with a circulating serum creatinine level of 1000 micromol/l. In group 1 (n = 6) a leucocyte filter was included in the circuit and in group 2 (n = 6) non-filtered blood was used.
Results:
The mean(s.d.) area under the curve for serum creatinine was lower in the leucocyte-depleted experiments (1286(214) versus 2627(418); P = 0.002). Leucocyte depletion also led to improved urine output (191(75) versus 70(32) ml/h; P = 0.002) and higher creatinine clearance (10.6(2.8) versus 1.9(1.0) ml/min; P = 0.002). Renal blood flow, oxygen consumption and acid-base homeostasis were all improved by perfusion with leucocyte-depleted blood, and histological tubular damage was ameliorated.
Conclusion:
These data show that the depletion of leucocytes from blood used to perfuse porcine kidneys improved postschaemic renal function, indicating that white cells play an important role in renal ischaemia-reperfusion injury.
