Canine renal glomerular ultrastructural changes after preservation and autotransplantation

Glomeruli of canine kidneys were studied by light and electron microscopy to determine whether significant structural alterations occur during 24 hr of hypothermic perfusion. The kidneys of eight dogs were preserved by continuous pulsatile perfusion with cold cryoprecipitated plasma; they were subsequently reimplanted as autographs and contralateral nephrectomy was performed at that time. Biopsies of the experimental kidneys were taken before nephrectomy, after 24 hr of perfusion, and at 1 hr postanastomosis. Tissue samples from two animals were studied at autopsy. Structural changes observed in the glomeruli after preservation were: margination of nuclear chromatin, nuclear pyknosis, and dilation of smooth and rough endoplasmic reticulum membranes. These changes were observed in all cell types, but were more severe in the endothelial cells. The basement membrane in four cases was edematous and thickened. At 1 hr postanastomosis the glomerular ultrastructural appearance was greatly improved. Blood urea nitrogen, serum creatinine, and the ability of the kidney to sustain the life of the recipient were used as criteria for determining the viability of the preserved kidneys. Blood urea nitrogen and serum creatinine returned to a normal range in five dogs. The physiologic tests and the length of survival attest to the functional capability of the preserved kidneys. Study of tissue samples at autopsy indicated that, although a number of the structural alterations observed after preservation were reversible, some changes persisted.