Primärfunktion warmischämisch geschädigter Schweinenieren nach retrograder Sauerstoffpersufflation, hypothermer Lagerung oder Maschinenperfusion

Kidneys of 37 pigs were exposed to warm in situ ischemia (WI) for 60, 90 or 120 min. Then 16 kidneys were subjected to retrograde persufflation with gaseous oxygen (ROP) for 4 hrs at 4°C, 5 kidneys treated by hypothermic machine perfusion (only 60 min WI), and 16 controls received only cold storage in UW-solution. After contralateral nephrectomy and autotransplantation only in the group with 60 WI and ROP none of the animals died of uremia. They showed primary renal function with maximal plasma creatinine on day 2 (6,1 mg/dl) and nearly normal values on day 7 (2,1 mg/dl). All of the other groups lost animals due to uremia and the survivors had significantly higher creatinine levels (ANOVA, p < 0,05) which did not normalize until day 7. In this setting ROP was superior to machine perfusion, however, the effect was restricted to kidneys with a warm ischemic insult of 60 min.