raffinose and Heart-Arrest

Topics: Adenosine; Allopurinol; Cadaver; Cold Temperature; Glutathione; Graft Survival; Heart Arrest; Humans; Hypertonic Solutions; Insulin; Kidney Transplantation; Organ Preservation; Organ Preservation Solutions; Perfusion; Raffinose; Time Factors; Tissue Donors

This study investigated iron-induced injury after warm ischemia in a non-heart-beating (NHB) rat liver model and the effects of deferoxamine (DFO). Livers from heart-beating (HB) rats or rats that were NHB for 60 minutes were stored in University of Wisconsin solution for 5 hours at 4°C [cold storage (CS)] and then were subjected to 2 hours of machine reperfusion (MRP) at 37°C. Three NHB groups were compared: (1) no DFO, (2) DFO 30 minutes before cardiac arrest and during CS and MRP, and (3) DFO during CS and MRP. Aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) levels in the NHB perfusate were significantly elevated (P < 0.01) in comparison with levels in HB controls after CS and MRP. After CS, the levels of iron and tumor necrosis factor α (TNF-α) were 0.077 ± 0.007 μmol/g and 151 ± 26 pg/g, respectively, in the NHB group and 0.022 ± 0.004 μmol/g and 17 ± 7 pg/g, respectively, in the HB group (P < 0.01). After MRP, LDH significantly correlated with iron (R(2)  = 0.81, P < 0.01). The DFO pretreatment of NHB donors decreased AST (7.3 ± 0.8 versus 4.0 ± 0.5 U/g of liver, P < 0.05) and LDH (42.5 ± 4.1 versus 20.4 ± 2.5 U/g of liver, P < 0.05) with 2 hours of MRP and increased bile flow during MRP (142 ± 34 versus 240 ± 18 μL/g, P < 0.05). It also reduced the levels of iron (0.077 ± 0.007 versus 0.050 ± 0.008 μmol/g, P < 0.05) and TNF-α (151 ± 26 versus 51 ± 13 pg/g, P < 0.05) after CS and the levels of lipid peroxidation products F2-isoprostane (149 ± 11 versus 99 ± 10 ng/g, P < 0.05) and malondialdehyde (1.58 ± 0.1 versus 1.14 ± 0.08 μmol/g, P < 0.05) after MRP. In conclusion, iron-initiated oxidative stress is likely involved in NHB donor liver injury, and importantly, DFO pretreatment reduces liver damage.

Topics: Adenosine; Allopurinol; Animals; Aspartate Aminotransferases; Bile; Deferoxamine; Disease Models, Animal; F2-Isoprostanes; Glutathione; Heart Arrest; Insulin; Iron; L-Lactate Dehydrogenase; Liver; Liver Diseases; Male; Malondialdehyde; Organ Preservation Solutions; Oxidative Stress; Perfusion; Raffinose; Rats; Tumor Necrosis Factor-alpha; Warm Ischemia

Use of grafts from donors after cardiac death (DCD) would greatly contribute to the expansion of the donor organ pool. However, this requires the development of novel preservation methods to recover the organ from changes due to warm ischemia time (WIT).. Porcine livers were perfused with a newly developed machine perfusion (MP) system. The livers were perfused with modified University of Wisconsin solution (UW) - gluconate. All grafts were procured after acute hemorrhagic shock with the ventilator off. For group 1 (n = 6), grafts were procured after WIT of 60 minutes and preserved by hypothermic MP (HMP) for 3 hours. For group 2 (n = 5), grafts were preserved with 2 hours of simple cold storage (SCS) and HMP for 2 hours. For group 3 (n = 6), grafts were preserved with 2 hours of SCS and rewarming up to 25°C by MP for 2 hours (RMP). The preserved liver grafts were transplanted orthotopically.. The alanine aminotransferase level in perfusate in RMP during perfusion preservation was maintained at less than that of HMP. The levels of aspartate aminotransferase and lactate dehydrogenase in the 2 hours after reperfusion were significantly lower in group 3. Histologically, the necrosis of hepatocytes was less severe in group 3. The survival rate in group 3 was 2/4, but 0/4 in the other group.. RMP is expected to facilitate the recovery of the DCD liver grafts.

Topics: Adenosine; Alanine Transaminase; Allopurinol; Animals; Aspartate Aminotransferases; Biomarkers; Cold Ischemia; Disease Models, Animal; Female; Glutathione; Graft Survival; Heart Arrest; Hepatectomy; Insulin; L-Lactate Dehydrogenase; Liver; Liver Transplantation; Necrosis; Organ Preservation; Organ Preservation Solutions; Perfusion; Raffinose; Reperfusion Injury; Rewarming; Sus scrofa; Time Factors; Tissue and Organ Harvesting; Warm Ischemia

Redox-active iron, catalyzing the generation of reactive oxygen species, has been implicated in experimental renal ischemia-reperfusion injury. However, in clinical transplantation, it is unknown whether redox-active iron is involved in the pathophysiology of ischemic injury of non-heart-beating (NHB) donor kidneys. We measured redox-active iron concentrations in perfusate samples of 231 deceased donor kidneys that were preserved by machine pulsatile perfusion at our institution between May 1998 and November 2002 using the bleomycin detectable iron assay. During machine pulsatile perfusion, redox-active iron was released into the preservation solution. Ischemically injured NHB donor kidneys had significantly higher perfusate redox-active iron concentrations than heart-beating (HB) donor kidneys that were not subjected to warm ischemia (3.9 +/- 1.1 vs. 2.8 +/- 1.0 micromol/L, p = 0.001). Moreover, redox-active iron concentration was an independent predictor of post-transplant graft viability (odds ratio 1.68, p = 0.01) and added predictive value to currently available donor and graft characteristics. This was particularly evident in uncontrolled NHB donor kidneys for which there is the greatest uncertainty about transplant outcomes. Therefore, perfusate redox-active iron concentration shows promise as a novel viability marker of NHB donor kidneys.

Topics: Adenosine; Allopurinol; Cadaver; Cell Survival; Glutathione; Graft Survival; Heart Arrest; Humans; Hypothermia; Insulin; Iron; Ischemia; Kidney; Kidney Transplantation; Organ Preservation Solutions; Oxidation-Reduction; Perfusion; Predictive Value of Tests; Raffinose; Reactive Oxygen Species; Tissue Donors; Treatment Outcome

The aim of this study was to determine the potential benefit of aerobic machine preservation (MP) with non-colloidal histidine-tryptophan-ketoglutarate (HTK) solution compared with MP with Belzer machine perfusion solution (MPS) and standard cold storage, after marginal kidneys had been obtained from non-heart-beating donors. Cardiac arrest was electrically induced in anaesthetized German landrace pigs (20-25 kg bw). Their kidneys were harvested 40 min thereafter, flushed with HTK by gravity of 100 cm H2O via the renal artery and then stored in HTK for 18 h at 4 degrees C. Other organs were subjected to oxygenated (pO2>500 mmHg) hypothermic pulsatile low-flow machine perfusion with HTK or MP with Belzer MPS at P(max)=40 mmHg, yielding transrenal flow values of 0.2-0.3 ml/min per g with HTK and approximately twice that amount with Belzer MPS. A well-preserved vascular endothelium and intact tubular epithelium were documented by electron microscopy at the end of perfusion preservation in both solutions as well as after cold storage. Concentrations of ATP (in micromoles per gramme) in tissue homogenates at the end of perfusion preservation with HTK were 1.18+/-0.12 vs 0.16+/-0.02 (P<0.05) after simple cold storage and 2.43+/-0.23 after perfusion with Belzer MPS, thus documenting a relevant effect of low-flow perfusion on tissue oxygenation. Viability of the grafts was followed for 1 week after heterotopic transplantation and bilateral nephrectomy in the recipient pigs. Machine perfusion with HTK significantly improved cortical microcirculation upon early reperfusion in vivo, as well as maximal serum levels of urea and creatinine, compared to recipients receiving cold-stored grafts. No differences could be found between MP with HTK or Belzer MPS. In conclusion, provision of oxygen during storage is possible by low-flow perfusion with HTK as with Belzer MPS and apparently improves graft viability after transplantation.

Topics: Adenosine; Adenosine Triphosphate; Allopurinol; Animals; Endothelium, Vascular; Glucose; Glutathione; Heart Arrest; Insulin; Kidney; Kidney Transplantation; Mannitol; Microcirculation; Microscopy, Electron; Organ Preservation; Organ Preservation Solutions; Oxygen; Oxygenators; Partial Pressure; Perfusion; Potassium Chloride; Procaine; Raffinose; Renal Circulation; Swine; Tissue Donors

Donation of kidneys from non-heart beating donors (NHBD) is increasingly being used to expand the donor pool. Warm ischemic injury of these kidneys suffered at harvest results in DGF at transplantation. In this study, we used hypothermic continuous machine perfusion preservation to mitigate this injury using two available solutions.. Dog kidneys (beagles) were exposed to 0, 60, or 75 min of in situ warm ischemia (37 degrees C), followed by 24 to 72 hr preservation by machine perfusion with Belzer MPS solution or the UW-solution (Viaspan). Auto-transplantation was performed with immediate contralateral nephrectomy. Survival and renal function (serum creatinine) were evaluated for up to 10 days posttransplant.. Both solutions were equally effective for 72 hr machine perfusion preservation of dog kidneys giving 100% survival with only minor renal injury. Both solutions were also equally effective for preservation of kidneys exposed to 60 min of warm ischemia. However, only the UW solution gave reliable preservation (86% survival vs. 25% survival) in kidneys exposed to 75 min of warm ischemia and 24 hr machine perfusion.. UW solution used with continuous hypothermic machine perfusion preservation can rescue canine kidneys from severe warm ischemic injury.

Topics: Adenosine; Allopurinol; Animals; Body Temperature; Cryopreservation; Dogs; Female; Glutathione; Graft Survival; Heart Arrest; Insulin; Kidney; Kidney Transplantation; Organ Preservation; Organ Preservation Solutions; Perfusion; Raffinose; Time Factors

The objective of the present study was to evaluate the recently proposed aerobic machine preservation with the noncolloidal HTK solution by comparison with the colloidal Belzer machine perfusion solution (MPS) after procurement of marginal kidneys from non-heart-beating donors. Kidneys were harvested 40 minutes after cardiac arrest in German Landrace pigs and subjected to 18 hours of oxygenated hypothermic machine perfusion with either Belzer MPS or modified HTK via the renal artery (Psys < 40 mm Hg). During machine perfusion transrenal flow was approximatively twofold higher and calculated oxygen uptake was increased by 30% using the colloidal Belzer MPS, but overall enzyme release was comparable in both groups. After heterotopic transpantation with bilateral nephrectomy of the recipient, there were no differences with respect to initial tissue perfusion in vivo (evaluated by laser Doppler flowmetry) as well as urine production and median serum levels of urea or creatinine over 1 week of follow-up between grafts perfused with HTK or Belzer MPS. In conclusion, provision of oxygen during storage is possible by low-flow perfusion with HTK as with Belzer MPS.

Topics: Adenosine; Allopurinol; Animals; Glucose; Glutathione; Heart Arrest; In Vitro Techniques; Insulin; Kidney; Kidney Function Tests; Mannitol; Models, Animal; Organ Preservation; Organ Preservation Solutions; Perfusion; Potassium Chloride; Procaine; Raffinose; Swine

Topics: Adenosine; Allopurinol; Animals; Glutathione; Heart Arrest; Insulin; Liver; Liver Function Tests; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Wistar; Tissue and Organ Harvesting; Tissue Donors

The chronic organ shortage has led to the reconsideration of marginal donor pools such as non-heart-beating donors (NHBD). The use of these livers is limited due to their minimal tolerance for cold preservation. The aim of this study was to examine the combination of two different therapeutic strategies for the preservation of livers from NHBD. The livers of male Wistar rats were harvested after the induction of cardiac arrest via phrenotomy (30, 90 minutes). Livers were perfused with 10 mL of UW solution (UW), followed by hypothermic preservation with or without insufflation of gaseous oxygen (O2). In one group a fibrinolytic preflush (10 mL of Ringer's containing 7500 IU of streptokinase) was performed with subsequent preservation with O2 (O2+SK). After storage (24 h/4 degrees C/UW) livers were reperfused in vitro. Livers retrieved from heart beating donors served as controls. The results showed that even after only 30 minutes of warm ischemia livers displayed a serious disturbance in vascular perfusion (portal venous pressure, PVP = 7.4 +/- 0.2* versus control: 4.1 +/- 0.5 mmHg), associated with a more than 10-fold increase in enzyme release (ALT: 26819 +/- 513* versus control 683 +/- 152 mU/g/L), which was consistent with a significant depression in bile synthesis (1.21 +/- 0.35* versus 19.36 +/- 2.16 microL/g/45 min). However, these impairments could be prevented with O2. Even after 90 minutes of WI, the function was significant better using aerobic preservation (ALT: 3204 +/- 549 mU/g/L). With a supplementary fibrinolytic preflush, we effectively preserved livers up to 90 minutes of WI with results comparable to livers from heart beating donors with no WI (ALT: 1623 +/- 432 mU/g/L). The combination of these two techniques represents a new therapeutic approach for livers with extended or unclear WI periods in non-heart-beating donors (*P <.05 versus control).

Topics: Adenosine; Aerobiosis; Allopurinol; Animals; Bile; Cell Death; Disease Models, Animal; Fibrinolysis; Glutathione; Heart Arrest; Hypothermia; Insulin; Liver; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Wistar; Vascular Resistance

Using in situ fluorescence microscopy with Sprague Dawley rats, we studied the hypothesis of compromised microvascular kidney perfusion on organ harvest in non-heart-beating donors (NHBDs), and we evaluated the potential benefit of an additional preflush with saline solution containing streptokinase. Aortal flush of NHBD kidneys solely with University of Wisconsin solution resulted in a significantly (P <0.05) reduced functional capillary density (FCD) with increased perfusion heterogeneity compared with kidneys of heart-beating controls. This was associated with an increased lactate dehydrogenase (LDH) release on 24 hr postpreservation rinse of the grafts (76.7+/-18.9 U/L). Warm preflush with low-viscosity Ringer's lactate (RL) solution alone did not influence the decreased renal FCD and the postpreservation LDH release (76.2+/-29.1 U/L). In contrast, the addition of streptokinase to the RL preflush solution resulted in a significant (P <0.05) improvement of FCD with values not statistically different from those of heart-beating controls. This was associated with an attenuation of perfusion heterogeneity and a significantly lowered postpreservation LDH release (17.0+/-2.5 U/L). Furthermore, in transplanted and reperfused NHBD kidney grafts, the use of streptokinase-supplemented RL for preflush during organ harvest significantly (P <0.05) reduced early manifestation of tubular necrosis (29%+/-8%) when compared with kidneys preflushed exclusively with University of Wisconsin solution (56%+/-4%). Thus, we conclude that kidney harvest from NHBDs is prone to severe microvascular perfusion deficits, which are likely to preclude successful preservation of organ integrity during cold storage. Temporary fibrinolytic preflush with streptokinase may represent a feasible tool to improve microvascular graft equilibration, which effectively protects the renal integrity during both cold storage and posttransplant reperfusion.

Topics: Adenosine; Allopurinol; Animals; Cold Temperature; Fibrinolytic Agents; Glutathione; Graft Survival; Heart Arrest; Insulin; Kidney; Kidney Transplantation; Male; Microcirculation; Organ Preservation Solutions; Perfusion; Raffinose; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Sodium Chloride; Streptokinase

The optimal method for preserving livers from non-heart-beating donors (NHBD) is still unknown. We compared the Celsior solution, a new extracellular-type, low-potassium, low-viscosity preservation solution, with the University of Wisconsin (UW) solution in a canine orthotopic liver transplantation from NHBD.. Fourteen adult mongrel dogs, weighing 9 to 17 kg, were divided into two groups: the Celsior or the UW group (n = 7 each). The thoracic descending aorta and supradiaphragmatic inferior vena cava were cross-clamped for 20 min to induce warm ischemia as a NHBD model. The liver was flushed with the respective cold preservation solution and then stored at 4 degrees C for 4 h. The grafts were transplanted using the piggy-back technique under portal decompression by leaving the native right lobe as a temporary shunt.. The duration of liver flushing out (min) was shorter (P < 0.05), and the serum glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, lactate dehydrogenase, lactate, and alpha-glutathione S-transferase concentrations 2 and 6 h after reperfusion of the graft (RPF) were lower (P < 0.05) in the Celsior group than in the UW group. Hepatic tissue blood flow (HTBF) did not deteriorate as much (P < 0.05) in the Celsior group. The serum endothelin-1 level was lower (P < 0.05) in the Celsior group 2 h after RPF. Histopathology of liver specimens revealed portal congestion and hepatocyte necrosis with neutrophil infiltration in the UW group, while these findings were mild in the Celsior group.. The Celsior solution improves vascular endothelial injury in livers from NHBDs and may have advantages in graft flush and preservation of grafts from NHBDs.

Topics: Adenosine; Alanine Transaminase; Allopurinol; Animals; Aspartate Aminotransferases; Disaccharides; Dogs; Electrolytes; Endothelin-1; Female; Glutamates; Glutathione; Glutathione Transferase; Graft Survival; Heart Arrest; Histidine; Insulin; L-Lactate Dehydrogenase; Lactic Acid; Liver; Liver Circulation; Liver Transplantation; Male; Mannitol; Neutrophils; Organ Preservation Solutions; Raffinose

Topics: Adenosine; Adenosine Triphosphate; Alanine Transaminase; Allopurinol; Animals; Female; Fibrinolysis; Glutamate Dehydrogenase; Glutathione; Heart Arrest; Insulin; Isotonic Solutions; L-Lactate Dehydrogenase; Liver; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Wistar; Ringer's Lactate; Streptokinase

Topics: Adenosine; Allopurinol; Animals; Apoptosis; Cell Death; Cold Temperature; DNA Fragmentation; fas Receptor; Glutathione; Heart Arrest; Hepatocytes; In Situ Nick-End Labeling; Insulin; Liver; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Wistar; Reperfusion; Time Factors

Our objective was to evaluate graft equilibration with high viscosity (University of Wisconsin solution [UW]) or low viscosity (Bretschneider's histidine-tryptophan-ketoglutarate [HTK]) during liver procurement from non-heart beating donors (NHBD) and the potential impact of a preceding fibrinolysis with streptokinase on postpreservation viability.. After 60 min of cardiac arrest, rat livers were perfused by gravity (60 cm H2O) via the portal vein with either 60 ml of HTK, 20 ml of UW, or 20 ml of Ringer's solution (22 degrees C including 7500U of streptokinase) and, subsequently, 20 ml of UW. After 24 h of storage at 4 degrees C, viability of the livers was assessed upon isolated reperfusion in vitro.. Magnetic resonance imaging revealed severe perfusion deficits, which were mildly attenuated with HTK, upon flush-out with UW. After preflush with streptokinase, a mostly homogenous distribution of the preservation solution was observed throughout the liver tissue. The choice of the flush-out solution (UW or HTK) had no influence on parenchymal enzyme leakage, hepatic bile production, or tissue levels of ATP after reperfusion of the livers. Fibrinolytic preflush, however, resulted in a relevant and significant improvement of structural integrity as well as functional and metabolic recovery.. Compromised vascular tissue perfusion upon organ harvest in NHBD triggers graft dysfunction after cold storage and can easily be circumvented by temporary fibrinolysis before graft retrieval.

Topics: Adenosine; Allopurinol; Animals; Energy Metabolism; Fibrinolytic Agents; Glucose; Glutathione; Heart Arrest; Insulin; Liver; Magnetic Resonance Imaging; Male; Mannitol; Organ Preservation Solutions; Potassium Chloride; Preoperative Care; Procaine; Raffinose; Rats; Rats, Wistar; Reperfusion Injury; Streptokinase; Tissue and Organ Harvesting; Tissue Donors; Tissue Survival

Topics: Adenosine; Allopurinol; Animals; Dogs; Glutathione; Heart Arrest; Heart Transplantation; Insulin; Kidney Transplantation; Lung Transplantation; Organ Preservation Solutions; Raffinose; Tissue and Organ Harvesting; Tissue Donors

Topics: Adenosine; Alanine Transaminase; Allopurinol; Animals; Glutathione; Graft Survival; Heart Arrest; Hyaluronic Acid; Insulin; L-Lactate Dehydrogenase; Liver Function Tests; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Raffinose; Swine; Temperature

Topics: Adenosine; Allopurinol; Anastomosis, Surgical; Animals; Glutathione; Heart Arrest; Iliac Vein; Insulin; Jugular Veins; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Perfusion; Raffinose; Spleen; Splenic Vein; Swine; Veins

Topics: Adenosine; Allopurinol; Animals; Aspartate Aminotransferases; Cold Temperature; Endothelin Receptor Antagonists; Glutathione; Graft Survival; Heart Arrest; Hyaluronic Acid; Insulin; L-Lactate Dehydrogenase; Liver; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Peptides, Cyclic; Perfusion; Piperidines; Platelet Activating Factor; Pyridinium Compounds; Raffinose; Swine; Transplantation, Homologous

Topics: Adenosine; Allopurinol; Animals; Glutathione; Heart Arrest; Hepatic Veins; Insulin; Ischemia; Liver; Liver Circulation; Male; Organ Preservation; Organ Preservation Solutions; Oxygen; Raffinose; Rats; Rats, Wistar; Reperfusion; Reperfusion Injury; Superoxide Dismutase; Tissue Donors

Topics: Adenosine; Allopurinol; Animals; Aspartate Aminotransferases; Biomarkers; Endothelin-1; Female; Glutathione; Heart Arrest; Hyaluronic Acid; Insulin; Liver; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Potassium Chloride; Raffinose; Swine; Tissue and Organ Harvesting

Topics: Adenosine; Adenosine Triphosphate; Allopurinol; Animals; Disaccharides; Dogs; Electrolytes; Glutamates; Glutathione; Heart; Heart Arrest; Histidine; Hydrogen-Ion Concentration; Insulin; Mannitol; Myocardium; Organ Preservation; Organ Preservation Solutions; Phosphates; Phosphocreatine; Raffinose

The objective of this study was to determine if allopurinol (AL) and/or trifluoperazine (TFP) added to the Belzer machine preservation solution (MPS) improves the function of non-heart-beating donor (NHBD) canine kidneys.. Anesthetized canines underwent bilateral dissection of the renal vessels, obtaining baseline flow. After removing one kidney (heart-beating donor [HBD]), the dog was exsanguinated. After remaining in situ for 120 min (30-min warm ischemia time, 90-min cold ischemia time), the second kidney was removed (NHBD), flushed, biopsied, and weighed. The kidneys were machine-perfused separately for 20 hr, and pressure, flow, and resistance were measured serially. The kidneys were randomly assigned to a perfusate group (G): G1=MPS, G2=MPS+TFP, G3=MPS+AL, and G4=MPS+TFP+AL. Kidneys were implanted separately into a single recipient dog. Flow, resistance, and urine output were measured serially for 4 hr. Blood and urine samples and kidney biopsies were then obtained. All measurements were standardized to 100 g of kidney weight.. HBD kidneys functioned better than NHBD kidneys in all groups, as expected. Although perfusate G1 was the most effective solution for HBD kidneys, the TFP additive (perfusate G2) more effectively reversed the vasospastic effects of ischemia/reperfusion for NHBD than the MPS solution (G1) with or without other additives. In HBD kidneys, the addition of AL resulted in the best creatinine clearance; however, AL was less effective than MPS alone in NHBD kidneys. TFP+AL together were completely ineffective in preserving renal function, regardless of whether the kidneys were from HBD or NHBD.. MPS+TFP more effectively protected renal function against reperfusion injury in the NHBD than MPS alone, AL, or AL+TFP. AL exerts a salutary effect on creatinine clearance in HBD but not in the NHBD. The TFP and AL combination should not be used together with the MPS in machine preservation of kidneys.

Topics: Adenosine; Allopurinol; Animals; Diuresis; Dogs; Female; Glutathione; Heart Arrest; Insulin; Kidney; Kidney Transplantation; Organ Preservation; Organ Preservation Solutions; Raffinose; Renal Circulation; Reperfusion Injury; Trifluoperazine

Topics: Adenosine; Allopurinol; Animals; Glutathione; Heart Arrest; Insulin; Kidney; Kidney Transplantation; Organ Preservation; Organ Preservation Solutions; Raffinose; Regional Blood Flow; Renal Artery; Reperfusion; Swine; Tissue Donors; Transplantation, Homologous

Topics: Adenosine; Allopurinol; Animals; Glutathione; Heart Arrest; Insulin; Ischemia; Kidney; Kidney Transplantation; Organ Preservation; Organ Preservation Solutions; Oxidative Stress; Rabbits; Raffinose; Renal Artery; Renal Veins; Reperfusion; Time Factors; Tissue Donors

Topics: Adenosine; Allopurinol; Animals; Disaccharides; Electrolytes; Glutamates; Glutathione; Graft Survival; Heart Arrest; Histidine; Insulin; Liver; Liver Transplantation; Mannitol; Necrosis; Organ Preservation; Organ Preservation Solutions; Raffinose; Swine; Tissue Donors; Transplantation, Homologous

Recovery of cardiac function and high-energy phosphates following ischemia and reperfusion were determined for hearts perfused with low potassium University of Wisconsin solution, high potassium University of Wisconsin solution, St Thomas' solution, or subjected to hypothermia alone. Isolated hearts were arrested for either 3 h at 15 degrees C or 6 h at 20 degrees C (n = 7 for each group) with one of the four solutions and then reperfused. Aortic flow after ischemic arrest at 20 degrees C was 40.3 +/- 13.3%, 79.3 +/- 10.0%, 64.3 +/- 11.9% and 43.9 +/- 15.9% of control values for high potassium University of Wisconsin solution, low potassium University of Wisconsin solution, St Thomas' solution and hypothermia alone, respectively. Similar results were observed in hearts subjected to ischemic arrest at 15 degrees C. Myocardial adenosine triphosphate and creatine phosphate after reperfusion tended to be higher in the low potassium University of Wisconsin solution group. It is concluded that low potassium University of Wisconsin solution may provide reliable cardioplegia during surgery that requires prolonged cardiac arrest in neonates and infants.

Topics: Adenosine; Adenosine Triphosphate; Allopurinol; Animals; Animals, Newborn; Bicarbonates; Calcium Chloride; Cardioplegic Solutions; Disease Models, Animal; Dose-Response Relationship, Drug; Glutathione; Heart; Heart Arrest; Heart Arrest, Induced; Hemodynamics; Hypothermia, Induced; In Vitro Techniques; Insulin; Magnesium; Organ Preservation Solutions; Phosphocreatine; Potassium; Potassium Chloride; Rabbits; Raffinose; Sodium Chloride

The organ donor shortage has led to a reconsideration of the use of non-heart-beating donors (NHBDs). However, graft injury due to warm ischemia in NHBD livers strongly affects posttransplant outcome. The present study was aimed at investigating the role of the cellular cyclic (c)AMP second messenger signal with regard to hepatic viability after cold preservation of NHBD livers.. Cardiac arrest was induced in Wistar rats by frenotomy of the anesthetized nonheparinized animal. After 30 min, the livers were excised and flushed with 20 ml of heparinized saline solution, rinsed with 10 ml of University of Wisconsin (UW) solution, and stored submerged in UW solution at 4 degrees C for 24 hr. In half of the experiments, UW solution was supplemented with glucagon (0.5 microg/ml) to increase the cAMP signal in the liver. Reperfusion was carried out in vitro after all livers were incubated at 25 degrees C in saline solution to replicate the period of slow rewarming during surgical implantation in vivo.. Hepatic levels of cAMP (nmol/g dry weight) declined from 1.21+/-0.05 to 0.53+/-0.03 (P<0.01) at 30 min after cardiac arrest. Subsequent storage in UW solution resulted in a further decline to 0.35+/-0.04 after 24 hr in group A, whereas glucagon treatment enhanced cellular cAMP signal to 0.64+/-0.06 (P<0.01). Upon reperfusion, liver integrity was significantly improved after glucagon administration, with 66% reduction in alanine aminotransferase release and a threefold increase in hepatic bile production as compared with untreated livers. Moreover, liver ATP tissue levels were restored to only 2.19+/-0.51 micromol/g in the untreated group but reached 4.97+/-0.41 micromol/g (P<0.05) after treatment with glucagon.. Posthoc conditioning of predamaged livers by glucagon enhances cAMP tissue levels during ischemic preservation and improves hepatic integrity upon reperfusion. This may represent a promising approach for the use of livers from non-heart-beating donors in clinical transplantation.

Topics: Adenosine; Adenosine Triphosphate; Alanine Transaminase; Allopurinol; Animals; Bile; Cryopreservation; Cyclic AMP; Glucagon; Glutathione; Heart Arrest; Insulin; Ischemia; Liver; Liver Circulation; Male; Organ Preservation Solutions; Raffinose; Rats; Rats, Wistar; Reperfusion; Signal Transduction; Tissue Donors

Topics: Adenosine; Allopurinol; Animals; Dogs; Female; Glutathione; Heart; Heart Arrest; Heart Transplantation; Insulin; Kidney Transplantation; Lung Transplantation; Male; Organ Preservation Solutions; Raffinose; Tissue Donors

Topics: Adenosine; Allopurinol; Animals; Gluconates; Glutathione; Graft Survival; Heart Arrest; Hypotension; Insulin; Liver; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Pentoxifylline; Perfusion; Raffinose; Swine; Transplantation, Homologous

Topics: Adenine Nucleotides; Adenosine; Allopurinol; Animals; Energy Metabolism; Glutathione; Graft Survival; Heart Arrest; Insulin; Liver; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Raffinose; Swine

Topics: Adenosine; Allopurinol; Animals; Glutathione; Graft Survival; Heart Arrest; Insulin; Lidocaine; Liver; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Raffinose; Survival Rate; Swine; Tissue Donors

Topics: Adenosine; Allopurinol; Animals; Glutathione; Heart Arrest; Humans; Hypertonic Solutions; Insulin; Isotonic Solutions; Kidney; Liver; Lung; Models, Biological; Organ Preservation; Organ Preservation Solutions; Pancreas; Raffinose; Ringer's Lactate; Swine; Temperature; Time Factors; Tissue Donors; Vasodilator Agents

Experiences in 145 cadaveric kidney transplantation from non-heart-beating donors showed that not only donor age and WIT but also recipient body weight and duration of hemodialysis dependency were the determining factors affecting posttransplant kidney function analyzed with the use of a stepwise logistic regression model. This suggests that the fluid burden on the graft provides an additional insult on the recovery of the grafts from ischemic injury.

Topics: Adenosine; Adolescent; Adult; Aged; Allopurinol; Catheterization; Child; Child, Preschool; Female; Follow-Up Studies; Glutathione; Graft Survival; Heart Arrest; Histocompatibility Testing; Humans; Hypertonic Solutions; Infant; Insulin; Kidney; Kidney Transplantation; Male; Middle Aged; Organ Preservation; Organ Preservation Solutions; Raffinose; Reoperation; Retrospective Studies; Time Factors; Tissue Donors; Treatment Failure

Topics: Adenosine Triphosphate; Allopurinol; Animals; Cardioplegic Solutions; Creatine Kinase; Glutathione; Heart; Heart Arrest; Hydrogen-Ion Concentration; Magnetic Resonance Spectroscopy; Myocardial Ischemia; Myocardium; Organ Preservation; Phosphates; Phosphocreatine; Phosphorus; Purines; Raffinose; Rats; Time Factors

Topics: Adenosine; Allopurinol; Animals; Blood Glucose; Cadaver; Dogs; Female; Glutathione; Graft Survival; Heart Arrest; Insulin; Male; Organ Preservation; Organ Preservation Solutions; Pancreas; Pancreas Transplantation; Raffinose; Temperature; Time Factors; Tissue Donors; Transplantation, Autologous

Topics: Adenosine; Allopurinol; Animals; Bile Ducts; Bilirubin; Cardiopulmonary Bypass; Dogs; Glucose; Glutathione; Heart Arrest; Humans; Insulin; Ischemia; Liver; Liver Transplantation; Mannitol; Organ Preservation; Organ Preservation Solutions; Potassium Chloride; Procaine; Raffinose; Swine; Temperature; Time Factors; Tissue Donors; Transplantation, Heterotopic

Topics: Adenosine; Alanine Transaminase; Allopurinol; Animals; Aspartate Aminotransferases; Glutathione; Graft Survival; Heart Arrest; Hepatectomy; Humans; Insulin; Ischemia; Liver; Liver Circulation; Liver Transplantation; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Wistar; Reperfusion; Tissue Donors

We have previously studied the time course of pulmonary cell viability, ultrastructural damage, and adenine nucleotide metabolites after circulatory arrest in a rat model to investigate the feasibility of lung retrieval for transplantation from cadavers. This study was designed to investigate the effect of hypothermic flush and subsequent 4-hour storage with either modified Euro-Collins or University of Wisconsin solution on lungs retrieved 4 hours after death.. Ninety-six Sprague-Dawley rats were sacrificed by intraperitoneal injection of pentobarbital. Control lungs were flushed immediately after sacrifice and stored for 4 hours. Rats in the experimental groups were sacrificed, and then their lungs were either ventilated with 100% oxygen or not ventilated for 4 hours before flushing with either Euro-Collins or University of Wisconsin solution followed by 4-hour hypothermic storage. At the end of the storage period, all right lungs were maintained at -70 degrees C and used to determine wet-to-dry weight ratios and adenine nucleotide levels with high-pressure liquid chromatography. Left lungs were assessed for viability with trypan blue dye exclusion. The effect on viability of flushing with Carolina rinse solution after storage was also assessed.. The percentage of viable cells in the control group after 4-hour hypothermic storage was 74% +/- 2% in Euro-Collins solution-flushed lungs and 78% +/- 2% in University of Wisconsin solution-flushed lungs. This result was virtually identical to that of lungs retrieved after 4 hours of in situ oxygen ventilation followed by 4 hours of hypothermic storage. Nonventilated cadaver lungs had substantially less viability. Adenosine triphosphate levels were significantly higher in the control group than in the oxygen-ventilated group, which were higher still than those in the nonventilated group. Adenosine triphosphate levels were consistently higher in University of Wisconsin solution-flushed lungs compared with Euro-Collins solution-flushed lungs in all groups. Total adenine nucleotide levels had a similar pattern. Wet-to-dry ratios were significantly lower in the control group (Euro-Collins = 6.27 +/- 0.46, University of Wisconsin = 4.63 +/- 0.07) compared with the oxygen-ventilated (Euro-Collins = 9.80 +/- 0.44, University of Wisconsin = 10.96 +/- 0.60) and nonventilated (Euro-Collins = 9.44 +/- 0.26, University of Wisconsin = 11.54 +/- 1.16; p < 0.0001) groups.. Four hours of circulatory arrest before 4 hours of hypothermic storage had no additional adverse impact on lung viability compared with lungs subjected to 4 hours of hypothermic storage alone, provided nonperfused lungs were ventilated with 100% oxygen. Adenine nucleotide levels were well maintained in oxygen-ventilated cadaver lungs, more so in University of Wisconsin solution-flushed lungs compared with Euro-Collins solution-flushed lungs.

Topics: Adenine Nucleotides; Adenosine; Adenosine Triphosphate; Allopurinol; Animals; Cadaver; Cardioplegic Solutions; Cell Survival; Chromatography, High Pressure Liquid; Cryopreservation; Feasibility Studies; Glutathione; Heart Arrest; Hypertonic Solutions; Insulin; Lung; Lung Transplantation; Organ Preservation; Organ Preservation Solutions; Organ Size; Oxygen; Raffinose; Rats; Rats, Sprague-Dawley; Respiration, Artificial; Solutions; Tissue and Organ Procurement; Tissue Survival

Topics: Adenosine; Allopurinol; Cadaver; Glutathione; Heart Arrest; Humans; Insulin; Kidney; Kidney Transplantation; Middle Aged; Organ Preservation; Organ Preservation Solutions; Raffinose; Renal Dialysis; Tissue Donors

Topics: Adenosine; Allopurinol; Animals; Dobutamine; Dogs; Glutathione; Heart Arrest; Heart Transplantation; Insulin; Organ Preservation; Organ Preservation Solutions; Raffinose; Reperfusion; Solutions; Stroke Volume; Time Factors; Transplantation, Heterotopic