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The composition of an organ preservation solution has a major influence on the functional quality of transplanted organs. Therefore in this study the influence of iloprost added to common organ preservation solution on the renal function was examined. Iloprost, being an analogue of prostacyclin, has got vasodilatory and profibrinolytic effects and inhibits platelet aggregation. For this purpose a model of isolated hemoperfused porcine kidney established by v. Baeyer and Grosse-Siestrup was used. 18 kidneys of german landrace pigs were hypothermically preserved over a period of 2 hours after which they were perfused with autologous blood. Three different organ preservation solutions were used for the purpose of hypothermical preservation: HTK solution (group I), Baeyer-2-solution (group II) and HTK solution with added iloprost (group III). Each group contained 6 kidneys which were hemoperfused over a period of 180 minutes. Blood and urin samples were taken every 30 minutes to evaluate renal function using the following parameters: sodium, blood gases, hemoglobin, creatinine, glucose, total protein, osmolality. Blood pressure as well as flow rate of blood and dialysate were measured. The following parameters were then calculated: renal resistance, creatinine clearance, sodium reabsorption, tubular sodium transport, oxygen consumption, diuresis, ratios of urine / plasma osmolality, protein, creatinine and glucose. The values after 60, 120 and 180 minutes were used for statistical analysis.
Regarding hemodynamic parameters kidneys of group II and III performed significantly better than those of group I. Blood flow rate after 180 minutes perfusion was 250ml/min*100g in group II and III whereas group I showed 136 ml/min*100g.
Renal resistance after 180 minutes perfusion was 0,30 mmHg*min*100g/ml in group II, 0,35 mmHg*min*100g/ml in group III and 0,66 mmHg*min*100g/ml in group I. Hence the addition of iloprost significantly improved renal hemodynamics in group III compared to group I and proved to be similar effective as group II.
Concerning functional parameters oxygen consumption stood out showing significant differences.
Oxygen consumption in group III was significantly higher at all measurements compared to group I as well as after 60 and 120 minutes compared to group II (medians after 60/120/180 minutes: group I 139/112/117, group II 103/98/82, group III 203/171/165 μmol/min*100g).
A possible reason could be less damage of functional nephrons and therefore better renal vitality in group III. Accordingly one would expect an increased tubular sodium transport which was the case in group III compared to group I. However, no significant differences were apparent among the three groups. Therefore an improved functionality could not be proven.
Adding iloprost to HTK solution improves the preservation quality to some extent and seems to be similar effective as Baeyer-2-solution.