Abstract:

Objective To evaluate the protective effect of continuous hypothermic machine perfusion transport system(Airdrive^TM) on cold ischemic injury of canine kidney. Methods Two kidneys of a healthy dog were taken out after general anesthesia. One kidney was stored using common cold preservation(CCP group) by immersing in the organ preservation solution, mixed with water and ice, and kept in a cold room at 4 ℃. The other kidney was stored using continuous machine perfusion preservation(CMP group) and was placed into the Airdrive^TM continuous machine perfusion device at room temperature. The renal tissues were examined by histopathology, electron microscopy, and mitochondrial activity was checked at different time points. Results Histologic sections showed that the structures of renal tissues of the 2 kidneys were similar during first 24 hours. After 48 hours, CCP group showed more pronounced changes, as the renal tubular epithelial cells were more obvious than those in the glomeruli. After 48 hours, CCP group showed more obvious morphological changes. The tubular and glomerular basement membranes had uneven thickness. The cell infoldings were obviously reduced and disordered. The electron density of the mitochondrial matrix was significantly decreased. The cristae were reduced and disarranged. Oxygen consumption rate of state Ⅲ and IV respiration in CCP group decreased after 12~48 hours and increased at 48 hours, respectively, when compared to continuous machine perfusion(CMP) group(P<0.05). At 48 hours, cortex respiratory control ratio(RCR) and phosphorus oxygen ratio(P/O) were significantly higher in the CMP group, compared to the CCP group. However, there was no significant difference between two kidneys at any other time points. Conclusion With prolonged storage time, the continuous hypothermic machine perfusion transport system showed better effect than that of common cold preservation on canine kidney. With increased use of marginal organs, the CMP will be further popularized clinically, and it has the ability to achieve the purpose of protecting the donor organs.

Key words: continuous hypothermic machine perfusion, organ preservation, organ transplantation, canine kidney, common cold preservation