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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ice-cold intracellular electrolyte flushing followed by cold storage and economy air shipment is the cheapest method to share kidneys for transplantation. This study from 1 center compares 62 primary cadaver kidney grafts imported from other centers to 128 that were retrieved locally. Cold ischemia time was 36.4 plus or minus 8.6 hours (mean plus or minus standard deviation) in the imported group and 24.2 plus or minus 8.8 hours in the locally retrieved group. The significant increase in first week dialysis (71 versus 42 per cent) and 1-month serum creatinine nadirs (2.63 plus or minus 2.73 versus 1.78 plus or minus 1.04 mg./dl.) was explained by longer cold ischemia times in the imported kidney grafts. There were no significant differences between the 2 groups with respect to actuarial kidney graft survivals and serum creatinine levels at 1, 2 and 3 years. Intracellular electrolyte flushing followed by simple cold storage and air transportation provides kidney graft survivals and long-term kidney graft function at minimal expense when the kidneys are retrieved from beating-heart cadavers and have undergone minimal warm ischemia.
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PMID:Comparison of imported with locally retrieved kidneys preserved by intracellular electrolyte flushing followed by cold storage. 633 44

Transplantation of cadaver kidneys after flushing with an ice-cold intracellular electrolyte solution is inhibited by arbitrary time limits on cold ischemia. During the 25-month interval ending March 22, 1982 we transplanted 7 kidneys preserved by this method and cold-stored for 48.2 to 61.4 hours. Of the recipients 86 per cent required dialysis within 1 week after transplantation, the mean serum creatinine nadir within 1 month was 2.1 mg./dl. and the graft survival at 1 month was 71 per cent. The 1-year actuarial cadaver graft survival was 69.2 plus or minus 18.1 per cent. Kidneys preserved by this simple method can be transplanted successfully after 48 hours of simple cold storage.
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PMID:Successful human kidney preservation by intracellular electrolyte flush followed by cold storage for more than 48 hours. 633 45

Transplant centers that do not have pulsatile machine perfusion capabilities are reluctant to accept kidneys from programs that do. Four human kidneys were retrieved by other centers, initially placed on pulsatile machine perfusion pumps for 13 to 28 hours, removed from the pumps, flushed with intracellular electrolyte solutions and cold-stored for 13 to 36 hours before transplantation at our institution. All recipients required dialysis during the first week after transplantation. The 1-month serum creatinine nadir was 2.2 plus or minus 1.1 mg. per dl., and all kidney grafts were functioning 3 months after transplantation. Pulsatile machine perfusion followed by ice-cold intracellular electrolyte flushing and simple cold storage can provide satisfactory renal function when the warm ischemia time is short.
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PMID:Human kidney preservation using machine perfusion followed by intracellular electrolyte flushing. 634 4

Prolonged cold storage following intracellular electrolyte flushing increases the probability of significant acute tubular necrosis after cadaver kidney transplantation. The renal function of primary cadaver kidney grafts was compared in 68 recipients who required dialysis and 92 who did not require dialysis during the first week after transplantation. All kidneys were retrieved from beating-heart cadaver donors by our center, flushed with ice-cold intracellular electrolyte solution and cold-stored until transplantation at our hospital. Recipients requiring dialysis during the first week after transplantation received kidneys with a significantly longer cold storage time (27.4 plus or minus 10.2 versus 23.2 plus or minus 7.6 hours) and had significantly higher 1-month serum creatinine nadirs (2.1 plus or minus 1.3 versus 1.5 plus or minus 0.6 mg./dl.). Actuarial kidney graft survivals and serum creatinine levels 1 to 5 years after grafting were not significantly different. Acute tubular necrosis following primary cadaver kidney transplantation does not adversely affect long-term function of kidney grafts flushed with intracellular electrolyte solution and cold-stored until transplantation.
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PMID:Influence of acute tubular necrosis on first cadaver kidney transplant function. 637 26

VIP containing nerves are present in the kidney and plasma VIP levels are elevated in cardiac failure and severe liver disease. We studied the effects of intravenous VIP; 6 pmol kg-1 min-1 on 6 normal subjects and 3 patients with liver disease. In normal subjects VIP produced flushing and significant rises in heart rate and pulse pressure but the clearance rates of paraaminohippurate and creatinine did not change significantly. Urine flow fell to about 1/3 and the rate of excretion of electrolytes (except phosphate) fell to about a half of control values. Plasma renin activity rose about 3-fold and there were significant rises in haematocrit and the plasma concentrations of solids, calcium and phosphate. The patients with liver disease responded similarly. Elevated plasma VIP could contribute to salt and water retention in disease states.
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PMID:Renal function during vasoactive intestinal peptide (VIP) infusions in normal man and patients with liver disease. 638 98

Rat kidneys were flushed in situ with selected preservation solutions prior to clamping the renal vessels for 1 hour. Collins and Euro-Collins flushing solutions did not appear to protect the physiologic or morphologic status of rat kidneys when examined 2 days after the ischemic insult. These experimental groups exhibited serum creatinine levels similar to those seen in ischemic controls, correspondingly low urine creatinine levels, anuria, and significant deterioration of the uriniferous tubules as revealed by light and electron microscopy. In situ flushing with hypertonic Sacks or isotonic phosphate-buffered sucrose solutions, however, resulted in significant improvements in serum and urine creatinine levels, prevented anuria, and dramatically improved the morphologic integrity of the uriniferous tubules. Flushing with a phosphate-buffered sucrose solution that contained ATP-MgCl2 further improved the physiologic and morphologic status of ischemic kidneys to the point that they were indistinguishable from the nonischemic controls. The degree of protection obtained by flushing kidneys with the isotonic phosphate-buffered sucrose solution plus ATP-MgCl2 is greater than that provided by any other single pretreatment or posttreatment for ischemia that is currently available. We, therefore, believe that the use of this procedure can provide a valuable approach to surgical situations in which postischemic acute renal failure is a potential problem.
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PMID:Protection of kidneys from acute renal failure resulting from normothermic ischemia. 660 9

No kidney transplant center responding to a kidney preservation questionnaire would accept a kidney flushed with an intracellular electrolyte solution and cold-stored for over 40 hours. This study from one center is a comparison of 50 primary cadaver kidney grafts preserved with an intracellular electrolyte flush followed by cold storage for 40 to 61 hours to 82 primary cadaver kidney grafts preserved by the same method for 9 to 24 hours. Kidneys cold-stored for over 40 hours had a significantly increased requirement for dialysis in the 1st week following transplantation (82% versus 34%) and a significantly increased 1-month serum creatinine nadir (2.3 mg/dL versus 1.7 mg/dL). Actuarial graft survivals and serum creatinine levels at 1, 2, and 3 years after grafting were not significantly different. Cadaver donor methylprednisolone (30 to 60 mg/kg) two to nine hours prior to kidney removal significantly reduced the requirement for 1st-week hemodialysis in the kidneys cold-stored for over 40 hours (60% versus 91%). Kidneys preserved by flushing with cold intracellular electrolyte solution can be successfully transplanted after over 40 hours of simple cold storage when the warm ischemia time is very short.
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PMID:Prolonged human kidney preservation by intracellular electrolyte flush followed by cold storage. 669 44

In order to differentiate the effects of swelling and anoxia on kidney function, a canine experimental model is used. After complete liberation of kidneys and their vessels from adjacent tissues, each kidney is submitted to 10 min of hypotonic flushing, or to 60 min of normothermic anoxia. Swelling resulting from these two procedures are equal and permit the study of the consequences of anoxia independently from swelling. Edema is determined by water content and renal blood flow is measured. Kidney function is studied by time of restoration of urinary flow, creatinine, and inulin clearances and fractional water reabsorption. The results show that nonanoxic edema is much less damaging than anoxic edema and consequently that anoxic injury is not the simple consequence of spatial disruption of cell architecture. Since many works have shown the beneficial effects of intracellular organ preservation solutions and consequently that anoxia is better tolerated in the absence of swelling, it can be deduced that injuries induced by anoxia and by swelling are cumulative and that the efficiency of intracellular solutions cannot be attributed solely to the preventive effect on swelling, considered as lethal for the cell.
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PMID:Differential effect of swelling and anoxia on kidney function and its consequences on the mechanism of action of intracellular organ preservation solutions. 675 25

Transplant teams have been reluctant to accept kidneys preserved with intracellular electrolyte flushing followed by simple cold storage, especially when retrieved by non-transplant surgeons or when preservation time exceeds 24 hours. This study from 1 center is a comparison of 40 primary cadaver kidney grafts preserved with Collins' C2 flushing followed by simple cold storage to 37 primary cadaver kidney grafts preserved with cryoprecipitated plasma on the MOX-100 machine. Cold storage time was 10 to 44.5 hours in the C2 group and 3.5 to 39 hours in the machine-perfused group, with a mean of 23 hours in each group. There was no significant difference between the 2 preservation methods no matter who removed the kidney with respect to 1) the incidence of acute tubular necrosis, 2) the 1-month serum creatinine nadir of surviving grafts and 3) the actuarial graft survivals up to 2 years. Among the 40 C2-preserved kidneys 17 were retrieved by community surgeons and 23 were retrieved by transplant surgeons. Human kidneys removed from beating-heart cadaver donors can be preserved satisfactorily with either Collins' 2 flushing followed by simple cold storage or pulsatile machine perfusion, even when preservation times exceed 24 hours.
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PMID:Comparison of intracellular flushing and cold storage to machine perfusion for human kidney preservation. 698 77

In 1976 a standardised hypertonic 'intracellular' perfusate (Euro-Collins solution) was recommended for renal preservation in all donor centres collaborating with the Eurotransplant Organisation. In order to investigate the effectiveness of this perfusate canine kidneys were initially flushed with Euro-Collins solution and subjected to 48, 72 and 96 h of cold storage and autotransplantated. Immediate contralateral nephrectomy was performed after autotransplantation. The serum creatinine served as a parameter of postoperative renal function. Under laboratory conditions successful preservation was achieved after minimal (less than 5 min) warm ischaemia for up to 96 h of cold ischaemia and after 15 min of warm ischaemia for up to 48 h of cold ischaemia. Our results suggest that initial flushing and hypothermic storage of kidneys using Euro-Collins solution is a satisfactory preservation method when human cadaver kidneys can be harvested under adequate conditions.
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PMID:48- to 96-hour preservation of canine kidneys by initial perfusion and hypothermic storage using the Euro-Collins solution. 699 10


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