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. 2001 Nov;1(4):316-20.
doi: 10.1034/j.1600-6143.2001.10405.x.

Hypothermia--a limiting factor in using warm ischemically damaged kidneys

L Brasile  1 , B M Stubenitsky, M H Booster, D Arenada, C Haisch, G Kootstra
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Free article

Hypothermia--a limiting factor in using warm ischemically damaged kidneys

L Brasile et al. Am J Transplant. 2001 Nov.
Free article

Erratum in

  • Am J Transplant. 2010 Dec;10(12):2729

Abstract

A study was performed to determine the limiting factors to expanding the donor pool with warm ischemically (WI) damaged kidneys. Canine kidneys were damaged by 30 min of WI, and then either cold stored (CS) in ViaSpan (4 degrees C) for 18 h, or warm perfused with exsanguineous metabolic support (EMS) technology (32 degrees C) for 18h, or subjected to combinations of both techniques. The kidneys were autotransplanted with contralateral nephrectomy. In kidneys with WI and CS alone, the mean peak serum creatinine value was 6.3mg/dL and took 14 days to normalize. In contrast, kidneys where renal metabolism was resuscitated ex vivo during 18 h of warm perfusion demonstrated mild elevations in the serum chemistries (2.6mg/dL). The damage in kidneys CS for 18h was ameliorated with 3 h of subsequent warm perfusion and eliminated by 18 h of warm perfusion. In contrast, reversing the order with CS following WI and 18h of warm perfusion resulted in a time-dependent increase in damage. These results identify hypothermia as a major limiting factor to expanding indications for kidney donation. While hypothermia represents the foundation of preservation in the heart-beating donor, its use in WI damaged organs appears to represent a limiting factor.

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