腎臓移植の研究 2.腎の保存に関する実験的研究:常圧および高圧酸素下低温灌流保存について

Abstract

The renal preservation with hypothermic (4℃) perfusion under normobaric or hyperbaric oxygen (2 atmospheres) has been performed. The preservation times were 6 hours and 12 hours. In order to study function of the preserved canine kidney, the extracorporeal circulation method was used. The normobaric preserved kidneys were compared with the hyperbaric preserved kidneys in respect to the direct renal blood flow (DRBF), PAH or STS extraction ratio (E-PAH or E-STS), PAH or STS clearance (C-PAH or C-STS), C-STS/C-PAH, the total renal resistance (TRR) and the histological findings. The pattern of renal blood flow during perfusion was investigated adding three nerve blocking agents to the perfusate by renal microangiography. Results: 1) DRBF of the normobaric preserved kidney was more than that of the hyperbaric preserved one. 2) E-P AH and E-STS of the hyperbaric preserved kidney were higher than that of the normobaric preserved one, however C-PAH and C-STS of the latter were higher than those of the former. 3) The tubular function decreased eminently compared with the glomerular function. 4) TRR of the normobaric preserved kidney was lower than that of the hyperbaric preserved one. 5) On histological findings, no difference between the normobaric and hyperbaric preserved kidney was observed at 6 hours, but the former had more severe damage compared with the latter at 12 hours. 6) Procaine was most effective to prevent the spasm of renal vessels during perfusion.