Immune response to storage-induced injury in non-ischaemic renal autografts

Graft sensitization was measured in dogs receiving autotransplants of perfused, flushed or hypothermically preserved kidneys. Five kidney treatments were studied: (1) continuous pulsatile perfusion with Ross solution for 24 h; (2) flush with Ross solution followed by 24h cold storage; (3) removal and immediate reimplantation; (4) flush with Ross solution and immediate reimplantation; (5) cool and immediate reimplantation. Continuous perfusion resulted in a lower mean creatinine (measured over the first five days after transplant) than did flushing followed by cold storage (P less than 0.001). Creatinines were lower in the groups in which kidneys were not stored (regardless of treatment) than in the stored groups (P less than 0.001). Dogs were said to be immune if their leucocytes were inhibited by nephrectomy kidney antigen in the leucocyte migration inhibition assay [LMI]. Immune dogs had a higher mean creatinine than non-immune animals (P less than 0.05). All autografts were examined for deposition of IgG, IgM and C3 at post-mortem by tissue immunofluorescence [IF]. Positive immune responses (LMI or IF) were seen more often in dogs receiving long preserved grafts than in those receiving immediate graft implantation (P less than 0.05).