Kidney transplantation after oxygenated machine perfusion preservation with Custodiol-N solution

摘要

Custodiol-N, a new preservation solution, has been shown particularly suitable for hypothermic machine perfusion preservation (HMP) in isolated porcine kidneys. These preliminary results should be confirmed in an actual transplant model invivo. Kidney function after 21h of HMP was studied in an autotransplant model using Landrace pigs (25-30kg; n=6 per group). Perfusion was performed with oxygenated perfusate, using either Custodiol-N solution including 50g/l dextran 40 (CND) or kidney perfusion solution 1 (KPS-1) as gold standard. Viability of the grafts was followed for 1week after bilateral nephrectomy in the recipient pigs. HMP with CND resulted in less acute tubular injury, evaluated by levels of fatty acid-binding protein and better clearance function during the first 24h after Tx than with KPS-1 (P<0.05, resp.). Serum creatinine tended to be lower in the CND group during the whole observation period. Histological tissue scores one week after Tx were similar in both groups. Expression of endothelin-1 as well as of Toll-like receptor 4 15min after reperfusion was lower in the CND group (P<0.05), suggesting less endothelial stress response. The data provide first invivo evidence for the suitability of Custodiol-N as an effective perfusate for renal machine perfusion.