Early graft function and intrarenal resistant index after kidney transplantation using Biolasol—A new solid organ preservation fluid

Abstract

Biolasol is a newly developed preserving solution for cold organ storage prior to transplantation. To date, only animal model experiments results are available. The aim of this single‐center analysis was to summarize the clinical experience concerning the early post‐transplant course of kidney grafts preserved with Biolasol in comparison with other preservation solutions. Before transplantation, 173 kidney grafts were preserved using Biolasol and 240 organs with other solutions (University of Wisconsin—UW, Institute Georges Lopez—IGL‐1, or StoreProtect Plus solutions). Early graft function was defined based on serum creatinine concentration at day 3 (<3 mg/dL—immediate graft function, IGF or >3 mg/dL—slow graft function, SGF) or the need of dialysis therapy during first post‐operative week (delayed graft function, DGF). The analysis included intrarenal resistive indices measured by Doppler sonography early after transplantation and before discharge from the hospital. IGF was more frequent in patients with organs preserved with IGL‐1 (33.5%) and StoreProtect Plus (38.8%) than Biolasol (18.5%), whereas there was no difference in the occurrence of DGF. Both initial and discharge median resistance index values were significantly higher in the Biolasol subgroup (0.77 and 0.75) than in all three other subgroups (P values for all comparisons <.001), also after 1:1 propensity score matching for baseline characteristics. Multiple logistic regression analysis based on the propensity score‐matched cohort revealed that the use of Biolasol solution [OR 0.59 (0.35‐0.98); P < .05] independently decreased the occurrence of IGF. In our single‐center clinical experience, kidney preservation using Biolasol solution was associated with significantly higher intrarenal resistant index in comparison with other preservation fluids, as well as worse early graft function than in the IGL‐1 and the StoreProtect Plus subgroups. Long‐term follow‐up is needed in order to assess the kidney graft and patient survival.

Hydrogen: Potential Applications in Solid Organ Transplantation

“…In severe cases, it may even cause primary graft dysfunction, prolong total hospital stay, and greatly increase mortality risk in solid organ transplant recipients [ 8 – 13 ]. Although various isolated organ protection platforms, such as ex vivo lung perfusion (EVLP) and LifePort Liver Transporter (LIFESPORT), have been developed clinically and extensive research and improvement have been achieved for organ preservation fluid [ 14 – 20 ], IRI cannot be completely prevented.…”