Background:
The organ shortage has led to increased employment of of warm ischemically (WI) damaged organs to expand the donor pool. Hypothermic machine perfusion (MP) has proven to be highly beneficial in preservation of WI damaged organs.
In this study, the efficacy of MP using the colloid-based 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 retrieved without WI, cold stored for 24h in HTK were used as controls.

Material and Methods:
The renal pedicle was clamped before retrieval for 45’ in the MP-Ecosol, CS-Ecosol and CS- HTK groups. After washout, kidneys (n=5/group) were preserved for 24h by MP or CS using their respective solutions and reperfused for 60' at 37°C with whole blood/Krebs-Henseleit Buffer medium (20/80%) for renal function assessment.

Result:
At 60' reperfusion, MP-Ecosol showed significantly higher urine output compared to CS-HTK and not different from CS-Ecosol and controls, mean±SEM: 332±54 vs 86±41 vs 197±27 vs 443±58 ml. Urine protein concentration and intravascular resistance were lower in MP-Ecosol and CS-Ecosol compared to CS-HTK and not different from controls (98±22 vs 94±34 vs 439±119 vs 70±19 mg/dl and 1.4±0.3 vs 0.5±0.1 vs 3.0±0.8 vs 0.6±0.1 mmHg/(ml/min)/100g resp.).

Conclusion:
MP using Ecosol solution attenuated extensive WI damage in porcine kidney grafts and demonstrated improved preservation quality compared to CS using HTK.