NINETY-SIX-HOUR PRESERVATION OF CANINE KIDNEYS

SUMMARY Dog kidneys under hypothermia were perfused with canine plasma or human albumin as perfusion medium for 90 hr and thereafter autotransplanted. During preservation, samples were taken at regular intervals from the perfusate, and the lactate and pyruvate concentrations were measured. A rising lactate to pyruvate ratio, explained by the accumulation of toxic metabolic products in the perfusate, was observed after 24 hr of perfusion; at this stage the perfusate was therefore exchanged. Successful 96-hr preservation was possible, as could be demonstrated by p-aminohippuric acid and inulin clearances and by the serum creatinine level after transplantation. Repeated perfusate exchange, however, did not enable further prolongation of the preservation period. Furthermore, successful 96-hr preservation was likewise possible when the perfusate volume was doubled and the perfusate was not exchanged. The conclusion is that for long-term kidney preservation a human albumin solution with high protein and normal sodium content should be used, that the perfusate volume should amount to at least 1,200 ml, and that perfusate exchange should be carried out after 24 hr of perfusion.