Perfusion Pressure in Kidney Preservation

Abstract

THE preservation of cadaver donor kidneys is becoming an important aspect of transplantation, and we recently developed a system which seemed to provide preservation of canine kidneys for up to 3 days with satisfactory subsequent function. The method consisted essentially of continuous perfusion with a homologous plasma per-fusate combined with hypothermia at 10° C, a pulsatile pump and a membrane oxygenator¹. One of the principal difficulties in perfusing isolated organs, such as the kidney, with plasma or blood at hypothermic temperatures is the development of a steady rise in perfusion pressure within a few hours, accompanied by a fall-off in flow rate, marked oedema and increase in weight of the organ, and a degree of cellular damage incompatible with subsequent functional recovery. Until recently the cause remained obscure, but evidence is now available which indicates a possible aetiology.