THE STUDY OF IN SITU RENAL PERFUSION
Comparison of Various Perfusate
1981 Volume 72 Issue 6 Pages 629-642
Details
1981 Volume 72 Issue 6 Pages 629-642
To protect renal parenchyma from ischemic damage during pedicle clamping for renal surgery, renal cooling by using in situ renal perfusion was performed. Fifty-six mongrel dogs which were unilaterally nephrectomised three or four weeks before were anesthesised. A KIFA red catheter was placed in the left renal artery and a KIFA black catheter was placed in the left renal vein, via the femoral vessles by Seldinger's method. The animals were divided into the following six groups and the kidneys were perfused.
Group I, control. Group II, normothermic ischemia. Group III, intermittent perfusion with 4°C cooled hyperosmoral lactated-Ringer's solution. Group IV, intermittent perfusion with 4°C cooled Sack's solution. Group V, continuous perfusion with Fluosol-43 at room temperature. Group VI, continuous perfusion with cooled Fluosol-43.
Two series of experiments were performed. In the first experiment renal function immediately after 90 or 180 min, of ischemic period with or without perfusion was determined. In the second experiment renal function was followed during recovery period from ischemia. RBF, Ccr, PSP excretion test, U/P osmolar ratio and GOT, GPT levels were evaluated in each dog. The left kidney was removed for histological studies.
The following results were obtained.
1) No urine production was found in Group II, but in Groups from III to VI, urine was obtained. However, renal function immediately after perfusion was reduced extremely.
2) The elevation of serum creatinine in the perfusion group was minimum. Serum creatinine level of one animal which belongs to Group III was elevated to 5.4 mg/dl on the third day after perfusion.
3) Renal function recovered to the normal range on the seventh day or the eighth day after perfusion except in group III.
4) Intracellluar hyperosmoral “Sack's” solution was the most suitable perfusate for in situ renal perfusion.
5) Renal function on the seventh or eighth day after perfusion was good in animals perfused with Fluosol-43 at room temperature.
6) The in situ renal perfusion would have definite advantages in certain renal procedures such as partial nephrectomy, renal artery replacement and certain cases of nephrolithotomy.
