[Evaluation of different preservation solutions utilized in the machine perfusion of kidneys retrieved under cardiac...

Considering the special demands of organs retrieved after cardiac death, the solution that should optimize and preserve the best early graft function and long-term graft survival remains to be determined. Recently, polyethylene glycol (PEG), high-molecular weight colloid, due to its protective effect against ischemia and reperfusion injury, has been proposed to be added to different preservation solutions for cold storage. Celsior formulation was targeted to fulfil the principles of organ preservation. The aim of our study was to evaluate Celsior plus PEG as a machine perfusion solution for kidneys retrieved after cardiac death. Landrace pigs were killed by lethal injection. Kidneys were submitted to warm and cold ischemic injuries mimicking the injury suffered by donation after cardiac death and were machine perfused with Celsior, Celsior plus 30 mg/l of PEG 20,000 Da and Belzer MPS. We demonstrate that when kidneys, submitted to warm and cold ischemia injury, were machine perfused with Celsior plus PEG the IRR were lower and the renal flow rates were higher in comparison with Celsior alone or Belzer MPS in the same conditions. This study provides the first evidence that Celsior plus PEG is an effective solution for machine perfusion of kidneys retrieved after cardiac death.