腎臓移植の研究 6. Perfluorochemical emulsionを用いた室温下腎潅流保存の実験的研究

Abstract

The functional and histological examination of the kidney were investigated after preservation by perfusion with perfiuorochemical (FC-43) emulsion at room temperature. The isolated dog kidney was washed out with physiological saline and perfused with following perfusate for 3-12 hours. The solution A contains 2.5 w/v% FC-43 in Ringer lactate solution, B contains 2.5 w/v% FC-43 in Collins' C3 solution and C is Collins' C3 solution without FC. Nonpulsatile perfusion was carried out under the condition of 95 mmHg pressure and fiowrate of 4-20 ml/min. Oxygen was continuously bubbled during perfusion. After completion of perfusion the kidney was connected to the external shunt prepared in femoral vessels of the same dog, and the extracorporeal circulation was opened. Urinary output was observed after perfusion of 3-4 hours in 2 out of 3 of A group, 6 out of 7 of B group and only lout of 4 of C group. The kidney function after extracorporeal recirculation in the B group was as follows. Creatinine clearance 2.0 mllmin, PAH clearance 11.0 ml/min after 2-4 hours and creatinine clearance 0.7 ml/min, PAH clearance 3.7 ml/min after 5-7 hours perfusion. Histological examination of the perfused kidney in A and C group revealed remarkable dilatation of glomerular capillaries and tubules and interstitial edema. On the contrary only little histological change was found in kidneys of group B. Autotransplantation of the kidneys in B group was performed after preservation for 2-6 hours by perfusion at room temperature. Three out of 6 kidneys after perfusion for 2 hours and lout of 5 kidneys after perfusion for 3 hours respectively maintained those functions.