Author(s): Isselhard W, Witte J, Denecke H, Berger M, Fischer JH
Retrograde persufflation of ischemic kidneys of dogs via the renal vein with gaseous O2 was evaluated as a method of kidney preservation (retrograde aerobic ischemia) and compared to conventional ischemic storage without additional measures (anaerobic ischemia). Renal preservationin situ lasted 4 hrs at 6°C. A contralateral nephrectomy was performed before the preservation period. For retrograde aerobic ischemia the persufflation pressure was 30 mm Hg, the gas flowed off via opened capsular vessels. While dogs which had undergone renal anaerobic ischemia showed a marked temporary post-ischemic increase in renal blood flow and in the systemic blood pressure, dogs submitted to renal retrograde aerobic ischemia did not exhibit a storage induced loss of the renal vascular autoregulation. During and after retrograde aerobic ischemia the renal tissue levels of ATP, ADP, and AMP remained within normal ranges; ATP and the sum of adenine nucleotides decreased markedly during anaerobic ischemia. In both the groups a normal renal function was resumed again; but the recovery time of various parameters of renal function (clearance from inulin and PAH, urea excretion, serum concentrations of urea and creatinine) was shorter after retrograde aerobic ischemia than after anaerobic ischemia. Kidneys subjected to retrograde aerobic ischemia exhibited a better functional adaption to the contralateral nephrectomy during the 3 weeks of post-ischemic observation than kidneys stored in anaerobic ischemia.