腎臓移植の研究 1.腎の保存に関する実験的研究:常圧酸素下低温浸漬保存について

Abstract

In order to study the function of preserved kidney, extracorporeal circulation of the preserved canine kidney was performed. The results were compared with the nonpreserved control groups in which the extracorporeal circulation was performed immediately after nephrectomy without washing out. The preservation of kidney was done after washing out with 5%LMWD in normal saline solution containing heparin and procaine, and stored in immersion solution (normal saline, 10% LMWD, plasma) at 4°C under normal oxygen pressure. The results are summarized as follows. 1) The function of the isolated kidney in control groups decreased eminently compared with one of living body. 2) The function of the isolated kidney by extracorporeal circulation tended to decrease along with the lapse of the circulating time. 3) The direct renal blood flow of the preserved kidney decreased slightly with the extent of preservation time. 4) The tubular function of the 12 hours preserved kidney showed considerably good conservation. Its PAR extraction ratio (E-PAH) was 43.1 % and PAR-clearance (C-PAH) was 38.5 % against the control groups. In 18 hours and 24 hours the preserved kidney showed negative value for E-PAH and zero value for C-PAH. 5) The glomerular function of the 12 hours and 18 hours preserved kidney were also considerably conserved. In 12 hours its E-STS was 56.0 % and C-STS was 42.6 % against the control groups, and in 18 hours E-STS and C-STS of the preserved kidney were 31.6% and 23.7% respectively, against the control groups. However, in 24 hours E-STS of the preserved kidney showed negative value and C-STS was zero. 6) Among the immersion solutions used, normal saline was able to preserve the renal function best, and there was no difference between 10% LMWD and plasma. 7) On the histological findings, no remarkable change could be found in 12 hours, 18 hours and 24 hours preserved groups.