Calcium ion concentration of machine perfusate predicts early graft function in expanded criteria donor kidneys

Maximilian M.R. Polyak, Ben O.Mar Arrington, Sandip Kapur, William T. Stubenbord, Milan Kinkhabwala

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Pulsatile preservation offers the advantage of pretransplant assessment of donor kidneys. Selected electrolyte concentrations of machine perfusate were measured over time in order to: (1) describe electrolyte changes in perfusate during the pulsatile preservation of expanded-criteria donor (ECD) kidneys, and (2) to assess the prognostic significance of these characteristics to early graft function. One hundred and fifty ECD kidneys were preserved in our laboratory between 1 January 1995 and 11 January 1997. ECD kidneys were defined as those requiring pretransplant biopsy. Kidneys were grouped by the presence or absence of delayed graft function (DGF), and perfusion parameters were measured every hour during pulsatile perfusion. All kidneys were preserved by continuous hypothermic pulsatile perfusion using Belzer II solution. Renal flow is decreased and renal resistance is increased in the presence of DGF in machine-preserved ECD kidneys. In addition, ionized calcium concentration of the machine perfusate is significantly elevated in the DGF group compared with the No DGF group (0.091 vs 0.054, P = 0.0016). The incidence of DGF is significantly lower in the ECD kidney. Among the pretransplant variables of donor characteristics, perfusion parameters and histology, perfusion parameters are highly predictive of early graft function. In addition, we found that ionized calcium concentration in the perfusate is significantly elevated in kidneys exhibiting DGF, which may have implications for assessing the suitability of donor kidneys for transplantation.

Original languageEnglish (US)
Pages (from-to)378-382
Number of pages5
JournalTransplant International
Volume12
Issue number5
DOIs
StatePublished - Oct 1 1999
Externally publishedYes

Keywords

  • Calcium
  • Kidney
  • Machine preservation
  • Marginal donor

ASJC Scopus subject areas

  • Transplantation

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