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Determination of warm ischemia time at donor nephrectomy
J G Maessen1, G J van der Vusse, M Vork
1Department of Surgery, University Hospital, University of Limburg, Maastricht, The Netherlands.
Transplantation
|January 1, 1988
Summary
A new index using adenine nucleotides (AN) and degradation products (DP) in kidney biopsies can accurately measure warm ischemia time. This ratio of DP to AN offers a reliable assessment for kidneys with unknown donor histories.
Area of Science:
- Biochemistry
- Nephrology
- Surgical Pathology
Background:
- Assessing warm ischemia time in donor kidneys with obscure histories is crucial for transplantation outcomes.
- Adenine nucleotide (AN) levels and their degradation products (DP) are sensitive indicators of cellular energy status and metabolic stress.
Purpose of the Study:
- To develop and validate a biochemical index for determining kidney warm ischemia time using AN and DP concentrations.
- To compare biopsy harvesting techniques and evaluate the impact of temperature on AN degradation during ischemia.
Main Methods:
- Canine kidney cortical wedge biopsies were subjected to varying durations of warm ischemia (0-120 min) at different temperatures (37°C and 32°C).
- Adenine nucleotides and their degradation products were quantified using high-performance liquid chromatography.
- The ratio of DP to AN was analyzed for correlation with ischemia duration.
Main Results:
- The ratio of degradation products (DP) to adenine nucleotides (AN) showed a significant correlation with warm ischemia time (P < 0.05).
- Lowering ischemia temperature reduced the catabolic rate of AN, altering the DP to AN ratio.
- The DP to AN ratio in human donor kidney biopsies aligned with findings in canine models, indicating potential clinical applicability.
Conclusions:
- The ratio of degradation products to adenine nucleotides in kidney biopsies serves as a sensitive index for assessing warm ischemia time.
- This biochemical marker is valuable for evaluating kidneys with unknown donor histories, potentially improving organ utilization in transplantation.