A New Solution for Initial Perfusion of Transplant Kidneys

Abstract

There is good evidence that blood should be removed from kidneys as completely as possible before they are transplanted. Rabbit kidneys, either freshly isolated or after one hour of warm ischaemia, were perfused with a solution of osmolality 400 mOsm/kg which contained high concentrations of Mg⁺⁺ (72 mEq) and glucose (167 mM). The rate and completeness of blood removal were measured by collecting effluent fractions until 100 ml had been perfused, and then assaying the haemoglobin in each effluent fraction and the residual haemoglobin in the kidney. A pressure of 60 mmHg was found to be sufficient for effective perfusion. The addition of 5% dextran 40 (Rheomacrodex) to the perfusate greatly improved the completeness of blood removal from kidneys subjected to one hour of warm ischaemia. Rabbit kidneys washed out with this solution functioned excellently after transplantation.