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NDT Advance Access originally published online on March 23, 2006
Nephrology Dialysis Transplantation 2006 21(7):1803-1808; doi:10.1093/ndt/gfl066
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Original Articles: Experimental Nephrology

Primary organ function of warm ischaemically damaged porcine kidneys after retrograde oxygen persufflation*

Jürgen W. Treckmann1, Andreas Paul1, Stefano Saad2, Julia Hoffmann3, Karl-Heinz Waldmann3, Christoph E. Broelsch1 and Manfred Nagelschmidt4

1 Department for General, Visceral and Transplantation Surgery, University Hospital of Essen, Hufelandstr. 55, 45122 Essen, 2 Clinic for Visceral, Vascular and Transplantation Surgery, University of Witten Herdecke, Hospital Cologne Merheim, Ostmerheimer Str. 200, 51109 Cologne, 3 Clinic for Swine, Small Ruminants, Forensic Medicine and Ambulatory Services, Veterinary School of Hannover, Bischofsholer Damm 15, 31073 Hannover and 4 Institute of Experimental Medicine, University of Cologne, Robert-Koch-Str. 10, 50931 Cologne, Germany

Correspondence and offprint requests to: Jürgen Treckmann, MD, Klinik für Allgemein- und Transplantationschirurgie, Universitätsklinikum Essen, Hufelandstr. 55, 45122 Essen, Germany. Email: j.treckmann{at}gmx.net

Background. As warm ischaemic damage is a major reason for the loss of donor organs, an experimental study was performed in order to evaluate retrograde oxygen persufflation (ROP) as a method to extend the warm ischaemic tolerance of kidneys.

Methods. Kidneys of 32 pigs were exposed to warm ischaemia for 60, 90 or 120 min. Then, 16 kidneys were subjected to ROP for 4 h at 4°C and 16 controls were stored in cold UW-solution, followed by autotransplantation.

Results. Only in the group with 60 min warm ischaemic time and ROP did all animals survive the observation period of 7 days. In all other groups some animals died due to anuria. Short-term survivors in these groups had significantly higher creatinine levels.

Conclusions. In this setting, ROP was superior to cold storage when applied after 60 min of warm ischaemia. Clinical evaluation of ROP in the setting of marginal donors and non-heartbeating donation is recommended.

Keywords: kidney transplantation; non-heartbeating donors; retrograde oxygen persufflation; warm ischaemia


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