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  • 1
    Electronic Resource
    Electronic Resource
    Outcome of machine-perfused non-heart-beating donor kidneys, not allocated within the Eurotransplant area (1998)
    Springer
    Transplant international 11 (1998), S. S421 
    Details
    ISSN: 1432-2277
    Keywords: Key words Non-heart-beating ; Donor kidney ; Machine perfusion ; Viability assessment ; Kidney transplantation ; αGST
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Eleven non-heart-beating (NHB) donor kidneys considered vital during machine perfusion (MP), could not be allocated inside Eurotransplant (ET). With the help of ET, five kidneys were transplanted in Karachi and six in Basel. Our goal was to prove that NHB kidneys successfully passing MP viability tests can be transplanted safely. Methods: Donor age, serum creatinine (some post-mortem) and warm ischaemic time were, respectively, (mean and range): 44 (14–70) years, 137 μmol/l, and 44 (9–80) min. Reasons for refusal were: bold ureter (one), suboptimal flush (one), relatively long hypotensive phase (seven), and donor age of 70 years (two). After 8 h of MP, mean lactate dehydrogenase, intrarenal resistance and alpha glutathione S-transferase were (including range): 556 U/l (range 366–819 U/l), 0.86 mmHg/ml per min (0.41–1.15 mmHg/ml per min) and 1188 μg/l (575–2677 μg/l), respectively. Mean cold ischaemic time was 45 (range 28–72) h. Results: Two kidneys showed immediate function, and nine showed delayed function. Mean creatinine levels after 1, 3 and 6 months were 295, 200 and 206 μmol/l, respectively. Four patients died for reasons not related to their kidney transplantation. Conclusions: We claim that MP can successfully assess viability of NHB donor kidneys. The reluctance to accept MP, and judged vital, NHB donor kidneys is no longer justified.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050513
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Kidney preservation in the next millenium (1999)
    Springer
    Transplant international 12 (1999), S. 83-91 
    Details
    ISSN: 1432-2277
    Keywords: Key words Kidney preservation ; Viability testing ; Ischemia ; Non-heart-beating donor ; Heart-beating donor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract For the past decades, severe hypothermia has represented the foundation of organ preservation in clinical transplantation. Beneficial as hypothermia has proven to be in preserving grafts from heart-beating donors, hypothermia does not seem to provide the window necessary for the prospective evaluation of organ function. With the increasing use of non-heart-beating donors, it is logical to propose that if organs are to be evaluated prospectively, it will be necessary to preserve them at warmer temperatures. Since both glomerular and tubular functions are inhibited at temperatures below 18 °C, such a goal will necessitate organ preservation at a temperature above 20 °C. The principle of preservation at warmer temperatures is not new, but with future developments and approaches, successful realization appears within reach. In this overview, a brief history of previous attempts at warm preservation, in the context of the current status of kidney preservation, is presented. Future developments and approaches, with the potential for prospective testing of the function and enhanced resistance to ischemic damage, will be discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050191
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    The value of dextran 12,000 in ischemically damaged canine kidneys during machine perfusion (1999)
    Springer
    Transplant international 12 (1999), S. 372-377 
    Details
    ISSN: 1432-2277
    Keywords: Key words Non-heartbeating ; Ischemic ; Kidney ; Dextran ; Effect ; Canine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The use of non-heartbeating (NHB) donor kidneys has led to the search for new methods of viability-testing. We investigated, in a canine model, the relationship between the filtration of dextran 12,000 into urine and a certain period of warm ischemic time (WIT) during machine perfusion. Twenty-four canine kidneys were divided into three groups, sustaining 0 min, 30 min or 60 min of WIT. After cooling and flushing, the kidneys were perfused on a perfusion machine for 8 h. Three hundred milligrams of dextran 12,000 was added to the perfusate. In the perfusate, dextran and lactate dehydrogenase (LDH) concentrations were measured. Dextran concentrations were also analysed in urine. Intrarenal vascular resistance (IRR) was calculated from pressure and flow characteristics. The 30WIT group showed a higher dextran excretion rate than the other two groups. IRR and LDH measurements showed lower levels in the ischemic groups compared with the control group. Dextran 12,000 is not suitable as a viability test but does show interesting results regarding the low LDH and IRR levels in the ischemic groups.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050242
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    Paper (German National Licenses)
    Fulltext
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