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Query: UMLS:C0022672 (acute tubular necrosis)
 2,175 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In unilateral nephrectomized beagle dogs the remaining kidney was subjected to 2 hrs of ischemia in situ. The ischemic organ was cooled to 22--23 degrees C by initial hypothermic perfusion over a 5-F catheter introduced into the renal artery via the carotid artery. It was then left in the open abdominal wound without any further attempts of cooling. Three perfusates were used: an isoosmolar Dextran solution (Eisenberger), a hyperosmolar, "intracellular" electrolyte solution (Sacks), and a hyperosmolar, "extracellular" electrolyte solution. There was a mean postoperative increase in serum creatinine levels of 0.6 mg-%. By the 3rd p.o. day at latest the serum creatinine was again within normal limits. The inulin and PAH clearances on the 7th and 14th p.o. day showed no significant differences to preoperative determinations. No definite advantage or disadvantage was noted among the three perfusates. All control dogs whose kidneys were made ischemic for 2 hrs without perfusion died due to acute tubular necrosis. Apparently the homogenous cooling and flushing by the initial perfusion is of more importance for good preservation in this situation than the composition of the perfusate.
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PMID:[Short time in-situ preservation of the ischemic kidney by a simple initial hypothermic perfusion with various cold solutions. An animal experimental study]. 115 70

Calcium channel blockade has been shown to prevent warm renal ischemic damage. The ability of verapamil to decrease the severity of acute tubular necrosis (ATN) after 24-hr cold storage and autotransplantation was studied in a randomized paired study of 12 dogs. Experimental animals pretreated with intraarterial verapamil and flushing of the harvested kidney with cold intracellular solution containing verapamil demonstrated significantly (P less than .05) greater renal function preservation over their matched controls. A subsequent nonpaired study of 6 dogs treated only with flushing of the harvested kidney with perfusate containing verapamil demonstrated no significant preservation advantage over controls. We conclude that verapamil, administered prior to the ischemic event, can enhance the protective effect of hypothermia and decrease the severity of ATN in ischemically injured kidneys.
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PMID:The effect of verapamil in reducing the severity of acute tubular necrosis in canine renal autotransplants. 330 60

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

Kidney preservation, often for periods in excess of 24 hours, is currently required to allow tissue matching and preparation of the recipient before cadaveric renal transplantation. Both flushing with complex electrolyte solutions and storage in ice saline slush, and hypothermic perfusion are satisfactory techniques. In half of the recipients, despite agonal damage in the donor and the progressive metabolic disturbance during hypothermic storage, the kidneys function immediately after transplantation. In the remaining half, kidneys function after a period of one to three weeks of acute tubular necrosis.
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PMID:Kidney perfusion and preservation. 675 90

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

Community urologists and general surgeons were recruited into a cadaver kidney program in 1976. This study from 1 center compares 41 primary cadaver kidney grafts retrieved by community hospital retrieval teams to 60 primary cadaver kidney grafts retrieved by a center-based transplant team. Of the kidneys 100 were preserved with Collins' C2 flushing followed by simple cold storage and 1 was preserved with pulsatile machine perfusion. Cold storage time ranged from 9 to 44.5 hours in the community hospital kidney group and from 11 to 44 hours in the university hospital group. There was no significant difference between the 2 kidney retrieval teams with respect to 1) incidence of acute tubular necrosis, 2) 1-month serum creatinine nadir of surviving grafts, 3) 1 and 2-year serum creatinine levels and 4) actuarial graft survivals up to 5 years. Community hospital retrieval teams can provide kidneys as satisfactory for transplantation as a center-based transplant team and are a valuable resource for cadaver kidney transplant programs.
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PMID:Effect of donor surgeon on first cadaver kidney transplant function. 703 41

Mechanical flushing of cadaveric kidneys with organ preservation fluid immediately before transplantation has been reported to be associated with improved early graft function. We report here the results of a prospective randomized controlled study of cadaveric renal transplantation after late reflush with organ preservation fluid in which no benefit with respect to delayed graft function was observed and, indeed, the protocol may have been harmful. The study was terminated after recruitment of only 18 patients (9 to each arm) because postreperfusion biopsies of reflushed kidneys contained unusual features, including abnormal cellular debris within the tubules or eosinophilic proteinaceous material within Bowman's capsule. These features were not present in the control kidneys. Acute tubular necrosis and biopsy-proven acute rejection episodes were more frequently seen in the reflushed kidneys, but at 1 year there was no significant difference in the function of the surviving grafts.
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PMID:Late reflush in clinical renal transplantation. Protection against delayed graft function not observed. 869 24