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Normothermic versus hypothermic ex vivo flush using a novel phosphate-free preservation solution (AQIX) in porcine kidneys.
J Surg Res. 2011 Nov; 171(1):275-82.JS

Abstract

BACKGROUND

The initial flush of an organ is important to remove any cellular components from the microcirculation before storage. The aim of this study was to assess graft function after an ex vivo warm flush with a novel non-phosphate buffered preservation solution AQIX RS-I (AQIX) compared with a traditional cold flush.

METHODS

Porcine kidneys were either warm-flushed with AQIX RS-I at 30°C, or cold-flushed at 4°C with University of Wisconsin solution (UW) or hyperosmolar citrate (HOC) preservation solution at a pressure of 100 cmH2O (n = 6). Renal function was measured ex vivo by perfusing the organs with autologous blood at 37°C on an isolated organ perfusion system.

RESULTS

The AQIX group flushed significantly quicker than the cold stored groups (22 ± 1.8 versus UW 4.9 ± 1.6 versus HOC 10 ± 1.6 mL/min/100g; P = 0.001) and gained less weight than the UW group (19 ± 2.9 versus UW 30 ± 3.4 versus HOC 21% ± 7.7%; P = 0.025). The AQIX group also had superior acid-base homeostasis. Functional results, histologic analysis, and ADP: ATP levels were comparable between the groups.

CONCLUSION

Flushing kidneys with AQIX at 30°C cleared the renal microcirculation of blood more rapidly without any detrimental effects when compared to traditional cold flushing with UW or HOC at 4°C. Warm initial flushing has potential to be developed as part of normothermic renal preservation techniques.

Authors+Show Affiliations

Department of Infection, Immunity, and Inflammation, Transplant Group, University of Leicester, Leicester General Hospital, Leicester, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20421110

Citation

Kay, Mark D., et al. "Normothermic Versus Hypothermic Ex Vivo Flush Using a Novel Phosphate-free Preservation Solution (AQIX) in Porcine Kidneys." The Journal of Surgical Research, vol. 171, no. 1, 2011, pp. 275-82.
Kay MD, Hosgood SA, Harper SJ, et al. Normothermic versus hypothermic ex vivo flush using a novel phosphate-free preservation solution (AQIX) in porcine kidneys. J Surg Res. 2011;171(1):275-82.
Kay, M. D., Hosgood, S. A., Harper, S. J., Bagul, A., Waller, H. L., & Nicholson, M. L. (2011). Normothermic versus hypothermic ex vivo flush using a novel phosphate-free preservation solution (AQIX) in porcine kidneys. The Journal of Surgical Research, 171(1), 275-82. https://doi.org/10.1016/j.jss.2010.01.018
Kay MD, et al. Normothermic Versus Hypothermic Ex Vivo Flush Using a Novel Phosphate-free Preservation Solution (AQIX) in Porcine Kidneys. J Surg Res. 2011;171(1):275-82. PubMed PMID: 20421110.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Normothermic versus hypothermic ex vivo flush using a novel phosphate-free preservation solution (AQIX) in porcine kidneys. AU - Kay,Mark D, AU - Hosgood,Sarah A, AU - Harper,Simon J F, AU - Bagul,Atul, AU - Waller,Helen L, AU - Nicholson,Michael L, Y1 - 2010/02/09/ PY - 2009/09/15/received PY - 2009/12/08/revised PY - 2010/01/13/accepted PY - 2010/4/28/entrez PY - 2010/4/28/pubmed PY - 2012/1/10/medline SP - 275 EP - 82 JF - The Journal of surgical research JO - J. Surg. Res. VL - 171 IS - 1 N2 - BACKGROUND: The initial flush of an organ is important to remove any cellular components from the microcirculation before storage. The aim of this study was to assess graft function after an ex vivo warm flush with a novel non-phosphate buffered preservation solution AQIX RS-I (AQIX) compared with a traditional cold flush. METHODS: Porcine kidneys were either warm-flushed with AQIX RS-I at 30°C, or cold-flushed at 4°C with University of Wisconsin solution (UW) or hyperosmolar citrate (HOC) preservation solution at a pressure of 100 cmH2O (n = 6). Renal function was measured ex vivo by perfusing the organs with autologous blood at 37°C on an isolated organ perfusion system. RESULTS: The AQIX group flushed significantly quicker than the cold stored groups (22 ± 1.8 versus UW 4.9 ± 1.6 versus HOC 10 ± 1.6 mL/min/100g; P = 0.001) and gained less weight than the UW group (19 ± 2.9 versus UW 30 ± 3.4 versus HOC 21% ± 7.7%; P = 0.025). The AQIX group also had superior acid-base homeostasis. Functional results, histologic analysis, and ADP: ATP levels were comparable between the groups. CONCLUSION: Flushing kidneys with AQIX at 30°C cleared the renal microcirculation of blood more rapidly without any detrimental effects when compared to traditional cold flushing with UW or HOC at 4°C. Warm initial flushing has potential to be developed as part of normothermic renal preservation techniques. SN - 1095-8673 UR - https://www.unboundmedicine.com/medline/citation/20421110/Normothermic_versus_hypothermic_ex_vivo_flush_using_a_novel_phosphate_free_preservation_solution__AQIX__in_porcine_kidneys_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-4804(10)00039-9 DB - PRIME DP - Unbound Medicine ER -