ISSN:
1432-2013
Schlagwort(e):
Renal Metabolism
;
Renal Preservation
;
Anaerobic Ischemia
;
Aerobic Ischemia
;
Renal O2-Persufflation
Quelle:
Springer Online Journal Archives 1860-2000
Thema:
Medizin
Notizen:
Summary The changes in the status of the adenylic acid-creatine phosphate system and in glycogen, glucose, and lactate were investigated in canine kidneys during preservation in anaerobic and aerobic ischemia at normo- and hypothermia. For anaerobic ischemia, the kidneys were stored without additional measures; for aerobic ischemia, the ischemic kidneys were persufflated with gaseous O2 or gas mixtures containing O2 via the renal artery or vein (orthograde and retrograde aerobic ischemia respectively). Prior to preservation, the kidneys were flushed with cell-free perfusates. Changes in the metabolic status characteristic of anaerobic ischemia were a decrease in the tissue levels of ATP, creatine phosphate, glycogen, glucose, and the sum of adenine nucleotides, a transitory increase in ADP and AMP, and an increase in the tissue level of lactate. Hypothermia caused a retardation of the anaerobic alterations; the loss of ATP was slowed down by factors of 2 and 9.5 when the temperatures were lowered from 37° to 26° and 6°C, respectively. In aerobic ischemia with orthograde and retrograde persufflation of 100% O2 (persufflation pressure = PP 60 and 30 mm Hg), deviations from a regular metabolic status developed very slowly. While the ATP-level decreased to 50% of the control value within scarcely 30 min of anaerobic ischemia at 6°C, it was almost 48 h before a similar loss of ATP occurred during orthograde aerobic ischemia at 6°C. Reduction of O2 in the persufflation gas to 40 and 21 vol-% resulted in less adequate preservation of the metabolic status. Increasing PP to 100 mm Hg for orthograde persufflation had no effect. An increase in PP to 60 mm Hg for retrograde persufflation resulted in a further delay in the metabolic deterioration. The long-term preservation of a regular metabolic status or the slow deviation of the metabolic pattern from the normal range during ischemia with O2-persufflation indicates a significantly smaller energy deficit than during storage in anaerobic ischemia. It must be attributed to a sufficient aerobiosis in the aerobically ischemic kidney, during which organogenic substrates brought in by the initial perfusion are utilized.
Materialart:
Digitale Medien
URL:
http://dx.doi.org/10.1007/BF00587833
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