Bootcongres

Background: Reperfusion injury after cold storage (CS) of organs is an inevitable consequence of a transplant procedure. We hypothesize that the sudden warm reperfusion after CS is detrimental for the graft. We therefore evaluated different warming-up temperatures of the organ before reperfusion in order to improve organ quality. Methods: Rat left kidneys were retrieved and stored in University of Wisconsin solution for 24 hours at 4°C followed by immediate reperfusion at 38 °C or gradually warming-up (WU) to 10°C , 25°C or 38°C, using isolated perfused kidney machine (IPK). Renal function and renal injury was assessed by IPK with an oxygenated modified Williams Medium E solution for a total of 90 minutes. Results: The increases in biochemical markers of injury such as AST and LDH in perfusate in the control group was significantly greater compared with WU groups (P<0.05). In the 10°C and 38°C WU groups NAG was significantly lower than the control group. Glomerular filtration rate (GFR) at the end of the reperfusion was similar in all the groups while ultra filtrate output was significantly higher in the control group. Sodium re-absorption improved in the WU groups and it was significantly greater in the 25°C WU group. Parallel to this, level of total protein was significantly lower in all the WU groups after 90 minutes reperfusion. KIM-1 and HSP-70 gene expression was reduced in the 10°C and 25°C WU groups compared to the control group. There were no differences in renal blood flow(RBF) and intra renal resistance(IRR) between the four groups after 90 minutes of reperfusion. ATP level did not change in all the four groups. Histological evaluation did not show significant differences between the groups. Conclusion: Gradually warming up is associated with less renal injury and better renal function indicating that reperfusion injury might be reduced.