The Effect of Modified University of Wisconsin Solution on Kidney Preservation Time

Abstract

Protection of organ function is important factor for the success of organ transplantation. Protection activity and also protection time period are dependent on a large scale of pre‐transplant preservation solutions. Therefore, donor organs are being preserved in special preservation solutions such as University of Wisconsin (UW), Histidin‐Triptophan‐Ketogluterate (HTK) and Celcior solution. For that aim, UW is the most preferred solution, even so, this solution could not preserve the organs over 36 hours. In this study, the ingredients of the UW solution were changed to extend the preservation time and also to provide more effective protection. Rat model is used for investigation of time related morphological changes between UW (group I) and Modified UW (Mod UW) (group II) solutions during preservation time. Rat kidneys were perfused with respective solutions. Totally perfused kidneys were removed and placed either in UW or Mod UW solutions and also kept during 2, 10, 24 and 72 h at 4° C. Kidney tissue samples were taken at given time intervals and fixed with 10% formaldehyde, and then these samples were prepared for paraffin sections. These tissue samples were also taken at 72nd hour, they were fixed in 2.5% glutaraldehyde and processed for epoxy resin embedding. For light microscopical evaluation, renal injury, based on tubular and glomerular degeneration, inflammatory cell infiltration, and vasocongestion has been scored with using a scale ranging from 0 to 3 (0: none; 1: mild; 2: moderate; and 3:severe) for each criterion. Liquid samples were also taken 2, 10, 24 and 72 h at 4° C from the storage media and investigated for LDH activity which was measured using standard chemistry method (Siemens ADVIA 1800 chemistry System). Microscopical examinations showed that Mod UW solution provided good preservation for all time intervals than UW solution. These results are consistent with lactate dehydrogenase (LDH) levels. Vacuolated tubular cells, as well as decreased renal tubules and glomerular degeneration described a prominent tissue injury revealed at 72nd h of UW group. Podocyte degeneration, formation of hump with GBM thickening revealed in 72nd h of UW group at transmission electron microscopical level. These degeneration parameters were observed less than in 72nd h of Mod UW group. It was concluded that Mod UW solution at low temperature is very effective and suitable for preservation up to 72 h.