Background:
The shortage of donor organs has necessitated expansion of the organ pool through increased employment of less than ideal donors. Venous Systemic Oxygen Persufflation (VSOP) has previously demonstrated promising results in preservation of warm ischemia (WI) damaged kidney grafts.

In this study, the efficacy of VSOP using the recently developed Ecosol preservation solution was assessed compared to cold storage (CS) using Ecosol or Histidine-Tryptophan-Ketoglutarate solution (HTK) for 24h preservation of WI-damaged kidney grafts using the Isolated Perfused Porcine Kidney model. Kidneys cold stored for 24h in HTK without WI served as controls.

Material and Methods:
Before retrieval, the renal pedicle was clamped for 45’ in the VSOP-Ecosol, CS-Ecosol and CS- HTK groups. Consequently, kidneys (n=5/group) were preserved for 24h and reperfused for 1h at 37°C with whole blood/Krebs-Henseleit Buffer medium for renal function assessment.

Result:
At 1h reperfusion, VSOP-Ecosol and CS-Ecosol showed significantly lower intravascular resistance and urine protein concentration compared to CS-HTK, not different from controls, mean±SEM: 0.6±0.0 vs 0.5±0.1 vs 2.8±0.9 vs 0.5±0.1 mmHg/(ml/min)/100g and 42±11 vs 106±35 vs 516±108 vs 72±18 mg/dl respectively. Urine production and fractional sodium excretion were improved in VSOP-Ecosol compared to CS-HTK, not different from controls (304±43 vs 79±42 vs 461±65 ml and 68±2 vs 90±3 vs 56±7% resp.)

Conclusion:
VSOP and CS using Ecosol resulted in improved preservation quality compared to CS using HTK. Moreover, VSOP using Ecosol enabled resuscitation of extensively WI damaged kidneys grafts.