Biochemical and morphological studies on human kidneys preserved for transplantation

Seven human kidneys that had been preserved for transplantation by pulsatile perfusion were studied to correlate the biochemical data with morphologic changes. Metabolite concentrations in mumol/g wet tissue were ATP = 0.26; ADP = 0.34; AMP = 0.45; lactate = 15.21; pyruvate = 0.23; 3-phosphoglycerate = 0.05; fructose-1,6-bisphosphate = 0.06; and hexose-6-phosphate = 0.03. Enzyme activities in mumol/min . mg protein found in the microsomal fraction were alkaline phosphatase = 0.049 and gamma-glutamyl transpeptidase = 0.844. Morphologically, none of the kidneys showed irreversible cell injury in the renal tubules, but some glomeruli showed areas where the endothelial cells appeared stripped off of the capillary basement membranes, indicating possible perfusion injury. The data suggest that it is the resynthesizing ability, as opposed to the absolute concentration of ATP, which determines the recovery and the subsequent viability of the tissue.