Improvement of postischemic renal function by limitation of initial reperfusion pressure

This study was designed to determine whether lowering the initial reperfusion pressure can improve renal function after ischemia. MATERIALS AND DESIGN: Sixty minutes of warm renal ischemia was induced in 2 groups of 8 minipigs by clamping the left renal artery. Right kidneys were kept in situ as controls. In the standard reperfusion group, ischemic kidneys were immediately reperfused at systemic pressure. In the controlled reperfusion group, the renal artery reperfusion pressure was maintained at 60 mm. Hg for the initial 20 minutes of reperfusion by use of a regulating pump and then at systemic pressure for the next 100 minutes.

On the basis of the postischemic anuria rate, glomerular filtration rate and renal histology, renal tolerance to ischemia was significantly improved in the controlled reperfusion group.

These findings of improved renal function recovery after warm ischemia by controlled low reperfusion pressure may have clinical relevance to the reperfusion technique used after renal transplantation in humans.