Renal preservation after warm ischemia using oxygen free radical scavengers to prevent reperfusion injury

Pedro Baron, Orlando Gomez-Marin, Camilo Casas, John Heil, Norman Will, Richard Condie, Barbara Burke, John S. Najarian, David E.R. Sutherland

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26 Scopus citations

Abstract

Oxygen free radicals damage kidneys and accumulate during the period of preservation prior to transplantation. We hypothesized that a perfusate containing either an oxygen free radical scavenger such as ceruloplasmin, or an iron-chelating agent such as deferoxamine, would improve kidney preservation. Thirty-eight mongrel dogs underwent autotransplantation of the left kidney after 30 min of warm ischemia and 48 hr of machine perfusion (MOX-100, Water Instruments, Rochester, MN) at 5°C and pH of 7.4. The right kidney was removed at the time of autotransplantation. Four blind code-labeled preservation solutions were tested. SGF-I was used for the control group (Group 1, n = 13), and the remaining animals were transplanted with kidneys preserved with one of three solutions modified from the basic SGF-I solution: Group 2, SGF-I plus deferoxamine (656 mg/liter), n = 8; Group 3, SGF-I ceruloplasmin enriched (72 mg/dl), n = 8; and Group 4, SGF-I ceruloplasmin reduced (3.4 mg/dl), n = 9. Serum creatinine levels were measured daily for 2 weeks and survival curves for each of the four groups were estimated by the Kaplan-Meier method. Peak mean serum creatinine levels ± standard errors in Groups 1 through 4 were 12.6 ± 1.97, 7.8 ± 0.90, 7.1 ± 1.26, and 8.2 ± 1.09, respectively. Repeated measures analysis of variance showed statistically significant differences between the groups with respect to their serum creatinine profiles (Wald's test χ2 with 3 df = 22.39, P value < 0.001). The significant differences in serum creatinine profiles were due to the consistently higher daily average values for Group 1 as compared with the other three groups. Survival rates 2 weeks after transplant were 31, 100, 63, and 67% for Groups 1 to 4, respectively. Comparison of the survival curves using the log-rank test showed statistically significant differences between the groups (χ2 with 3 df = 9.42, P value = 0.024). We conclude that deferoxamine and ceruloplasmin reduce the ischemia reperfusion injury that occurs after revascularization of renal transplants and may be useful for clinical kidney graft preservation.

Original languageEnglish (US)
Pages (from-to)60-65
Number of pages6
JournalJournal of Surgical Research
Volume51
Issue number1
DOIs
StatePublished - Jul 1991

ASJC Scopus subject areas

  • Surgery

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    Baron, P., Gomez-Marin, O., Casas, C., Heil, J., Will, N., Condie, R., Burke, B., Najarian, J. S., & Sutherland, D. E. R. (1991). Renal preservation after warm ischemia using oxygen free radical scavengers to prevent reperfusion injury. Journal of Surgical Research, 51(1), 60-65. https://doi.org/10.1016/0022-4804(91)90070-3