Efficiency and limitation of Euro-Collins solution in kidney preservation

The efficiency of Euro-Collins solution against cellular swelling and the reason for its 50-hr upper tolerance limit in kidney preservation prior to human transplantation is investigated. Dog kidneys were removed, flushed with saline, Euro-Collins, or a modified sucrose Euro-Collins solution, and stored at 4 degrees C in the same fluid for 96 hr. Total and intracellular water contents and intracellular sodium and potassium contents were calculated at various times according to a methodology taking into account the weight of the dry matter of the solution and the value of extracellular space determined from the inulin distribution space. Main results show that, in the Euro-Collins group, the intracellular water is unchanged up to 48 hr but is suddenly increased between 48- and 72-hr preservation, after which it remains unchanged. This marked cellular edema does not occur in the sucrose group. Euro-Collins solution is thus able to protect kidneys from cellular swelling and ionic changes during a 48-hr preservation period which corresponds to the upper tolerance limit admitted in clinical transplantation. The limiting factor of the swelling inhibition is the penetration of glucose into the cell and can be related to a first step in membrane injury. Some cellular components are, however, probably lost after 72-hr preservation, which suggests a second step in the membrane deterioration.