原著
心停止ドナーからのブタ腎保存における酸素化復温灌流保存方法の有用性の研究
キーワード:
marginal donor,
machine perfusion preservation,
delayed graft function (DGF),
ischemic reperfusion injury
2018 年 53 巻 1 号 p. 33-39
詳細
2018 年 53 巻 1 号 p. 33-39
【Objective】 The utilization of grafts from donors after cardiac death (DCD) would greatly contribute to the expansion of the donor organ pool. However, the implementation of such a strategy requires the development of novel kidney preservation methods to recover from an ischemic injury.
【Design】 The aim of this study was to evaluate the effectiveness of using oxygenated rewarming machine perfusion for preserving porcine DCD kidney grafts for transplantation.
【Methods】 Porcine kidneys were perfused with an original machine perfusion (MP) system. The kidneys were procured after 0 or 60 min. of warm ischemic time (WIT) and were perfused for 2 hours with modified UW-gluconate solution after 2 hours of simple cold storage. Group 1: The grafts with a WIT of 0 min were preserved using hypothermic MP (HMP). Group 2: The grafts with a WIT of 60 min were preserved using HMP. Group 3: The grafts with a WIT of 60 min were preserved using rewarming MP (RMP) at up to 25°C without oxygenation. Group 4: The grafts were preserved with a WIT of 60 min using oxygenated RMP.
【Results】 In Group 4, the effluent levels of the lactate dehydrogenase (LDH), but not CPK, were lower than those observed in Group 2. The vascular resistance (renal resistance; RR) was remarkably lower in Group 4 (p<0.01). A positive correlation was observed between RR and LDH.
【Conclusion】 Oxygenated subnormothermic preservation with rewarming may help in recovering the function of DCD kidney grafts.
