[Hemodynamic and hydrodynamic problems in kidney transplantation]

On the basis of general realisations and own experimental or clinical observations haemodynamic and hydrodynamic problems, respectively, of renal conditioning in the organism of the donor, the perfusion preservation and the phase of repeated blood supply are represented and discussed. It is shown that an improvement of the renal blood supply and of she flow of the urine in the donor with "dead brain" by alpha-adrenergic blockade or stimulation of beta-receptors is not sufficient for overcoming restrictions of the renal function. A pulsatile perfusion and the permanent opening of the vascular lumen when the medium changes between blood and perfusate are regarded as most favourable hydrodynamic prerequisites for the initial hypothermal lavation of blood. In continuous machine perfusion with oxygenated protein-containing solutions a dilation of the renal vessels takes place, so that the cortical perfusion is guaranteed also in low pressures. After the transplantation there exists a significant pathogenetic correlation between the total blood supply of the kidney and its early function.