Donor treatment with phentolamine mesylate improves machine preservation dynamics and early renal allograft function

Maximilian M R Polyak, Ben O'Mar Arrington, Sandip Kapur, William T. Stubenbord, Milan Kinkhabwala

Research output: Contribution to journalArticle

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Abstract

Background. It has been suggested that pharmacologic conditioning of the donor before organ procurement may protect the renal allograft from injuries associated with the cold ischemic period. We compared the administration of two vasoactive agents before organ procurement to: (1) determine their influence on machine perfusion characteristics and (2) determine their impact on delayed graft function (DGF) in transplanted renal allografts. Methods. Between January 1997 and December 1998, 150 kidneys were procured from heart- beating donors and preserved in our laboratory by machine perfusion (MP) or cold storage (CS). The following vasoactive agents were randomly administered to the donors min before aortic cross clamp: phentolamine mesylate (PM) or hydralazine (H). The control groups received no donor conditioning. Kidneys were grouped as follows: (1) MP+PM, (2) MP+H, (3) MP, (4) CS+PM, (5 CS+H, (6) CS. 10 mg PM/50 kg donor weight was administered to the PM groups and 20 mg H/50 kg donor weight was administered to the II groups. DGF was defined as the need for dialysis within the first 7 days after the transplant. Results. MP+PM increased renal flow by 12% and decreased renal resistance by 18% compared with the MP+H group, and increased renal flow by 23% and decreased renal resistance by 30% compared with the MP group. Moreover, the MP+PM group was associated with improved early allograft function. Conclusions. Donor treatment with PM immediately before aortic cross-clamp is associated with improved machine perfusion dynamics (renal flow and renal resistance) and lower incidence of DGF compared with donor treatment with H or no treatment. Moreover, MP of renal allografts was associated with improved early function compared with CS grafts.

Original languageEnglish (US)
Pages (from-to)184-186
Number of pages3
JournalTransplantation
Volume69
Issue number1
StatePublished - Jan 15 2000
Externally publishedYes

Fingerprint

Phentolamine
Allografts
Perfusion
Kidney
Delayed Graft Function
Tissue and Organ Procurement
Transplants
Weights and Measures
Hydralazine
Dialysis

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Donor treatment with phentolamine mesylate improves machine preservation dynamics and early renal allograft function. / Polyak, Maximilian M R; O'Mar Arrington, Ben; Kapur, Sandip; Stubenbord, William T.; Kinkhabwala, Milan.

In: Transplantation, Vol. 69, No. 1, 15.01.2000, p. 184-186.

Research output: Contribution to journalArticle

Polyak, Maximilian M R ; O'Mar Arrington, Ben ; Kapur, Sandip ; Stubenbord, William T. ; Kinkhabwala, Milan. / Donor treatment with phentolamine mesylate improves machine preservation dynamics and early renal allograft function. In: Transplantation. 2000 ; Vol. 69, No. 1. pp. 184-186.
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abstract = "Background. It has been suggested that pharmacologic conditioning of the donor before organ procurement may protect the renal allograft from injuries associated with the cold ischemic period. We compared the administration of two vasoactive agents before organ procurement to: (1) determine their influence on machine perfusion characteristics and (2) determine their impact on delayed graft function (DGF) in transplanted renal allografts. Methods. Between January 1997 and December 1998, 150 kidneys were procured from heart- beating donors and preserved in our laboratory by machine perfusion (MP) or cold storage (CS). The following vasoactive agents were randomly administered to the donors min before aortic cross clamp: phentolamine mesylate (PM) or hydralazine (H). The control groups received no donor conditioning. Kidneys were grouped as follows: (1) MP+PM, (2) MP+H, (3) MP, (4) CS+PM, (5 CS+H, (6) CS. 10 mg PM/50 kg donor weight was administered to the PM groups and 20 mg H/50 kg donor weight was administered to the II groups. DGF was defined as the need for dialysis within the first 7 days after the transplant. Results. MP+PM increased renal flow by 12{\%} and decreased renal resistance by 18{\%} compared with the MP+H group, and increased renal flow by 23{\%} and decreased renal resistance by 30{\%} compared with the MP group. Moreover, the MP+PM group was associated with improved early allograft function. Conclusions. Donor treatment with PM immediately before aortic cross-clamp is associated with improved machine perfusion dynamics (renal flow and renal resistance) and lower incidence of DGF compared with donor treatment with H or no treatment. Moreover, MP of renal allografts was associated with improved early function compared with CS grafts.",
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