A New Solution for Initial Perfusion of Transplant Kidneys

Abstract

There is good evidence that blood should be removed from kidneys as completely as possible before they are transplanted. Rabbit kidneys, either freshly isolated or after one hour of warm ischaemia, were perfused with a solution of osmolality 400 mOsm/kg which contained high concentrations of Mg++ (72 mEq) and glucose (167 mM). The rate and completeness of blood removal were measured by collecting effluent fractions until 100 ml had been perfused, and then assaying the haemoglobin in each effluent fraction and the residual haemoglobin in the kidney. A pressure of 60 mmHg was found to be sufficient for effective perfusion. The addition of 5% dextran 40 (Rheomacrodex) to the perfusate greatly improved the completeness of blood removal from kidneys subjected to one hour of warm ischaemia. Rabbit kidneys washed out with this solution functioned excellently after transplantation.

Rhesus immunization after Rh‐incompatible kidney transplantation

“…Reliable data for the volume of residual blood in human cadaver kidneys are not available. On the basis of results obtained with rabbit and rat kidneys (Foreman et al 1982, Wusteman et al 1978, Frodin 1975, it may be calculated that kidneys perfused with 500-1000 ml of Collins' solution immediately following nephrectomy, contain approximately 0.3 ml of blood. For kidneys perfused after one hour of warm ischemia the volume of residual blood could be as much as one milliliter, and for kidneys with infarction the figures arc probably highcr.…”