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Isolated kidney perfusion: the influence of pulsatile flow
Charlotte von Horn1, Thomas Minor1
1a Department of Surgical Research General, Visceral and Transplantation Surgery , University Hospital Essen, University Duisburg-Essen , Essen , Germany.
Scandinavian Journal of Clinical and Laboratory Investigation
|January 6, 2018
Summary
Pulsatile perfusion significantly improves kidney function and preservation after static cold storage compared to non-pulsatile methods. This technique enhances renal blood flow and reduces cellular injury, making it ideal for isolated kidney perfusion.
Area of Science:
- Transplantation research
- Organ preservation
- Renal physiology
Background:
- Ex vivo kidney perfusion is a key model for studying ischemia-reperfusion and preservation injury.
- Optimizing organ reconditioning and preparation before transplantation is crucial.
- Current perfusion techniques aim to mimic physiological conditions.
Purpose of the Study:
- To investigate the influence of pulsatile perfusion on renal perfusion characteristics and kidney function in isolated perfused kidneys.
- To compare pulsatile versus non-pulsatile perfusion modes.
- To assess the impact on vascular conductivity and tubular cell injury.
Main Methods:
- Isolated kidneys were perfused using a roller pump (non-pulsatile) or a positive displacement pump (pulsatile).
- Perfusion pressures were maintained at 90 mmHg (non-pulsatile) or 90/70 mmHg at 60/min (pulsatile).
- Renal flow rates, creatinine clearance, sodium reabsorption, and tubular cell injury markers (fatty acid binding protein) were measured.
Main Results:
- Pulsatile perfusion significantly enhanced renal flow rates, particularly after static cold storage.
- Improved vascular conductivity was observed with pulsatile perfusion.
- Enhanced creatinine clearance, sodium reabsorption, and reduced tubular cell injury were noted.
Conclusions:
- Pulsatile perfusion offers superior renal preservation and functional recovery compared to non-pulsatile methods in isolated kidney perfusion.
- The benefits are attributed to improved endothelial nitric oxide release and reduced endothelin-1 secretion.
- Pulsatile perfusion should be the preferred method for isolated kidney perfusion to optimize organ outcomes.
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