Organ Preservation: Basic and Applied Aspects A Symposium of the Transplantation Society PDF
Preview Organ Preservation: Basic and Applied Aspects A Symposium of the Transplantation Society
Organ Preservation Basic and Applied Aspects Organ Preservation Basic and Applied Aspects A SYMPOSIUM OF THE TRANSPLANTATION SOCIETY edited by D. E. Pegg I. A. Jacobsen and N. A. Halasz M~LIMITED International Medical Publishers LANCASTER· BOSTON·THE HAGUE Published in the UK and Europe by MTP Press Limited Falcon House Lancaster, England British Library Cataloguing in Publication Data Organ preservation. 1. Preservation of organs, tissues, etc.- Congresses 2. Transplantation of organs, tissues, etc.-Congresses I. Pegg, D. E. II. Jacobson, I. A. III. Halasz, N. A. IV. Transplantation Society 617'.95 RD129 ISBN-13: 978-94-011-6269-2 e-ISBN-13: 978-94-011-6267-8 001: 10.1007/978-94-011-6267-8 Published in the USA by MTP Press A division of Kluwer Boston Inc 190 Old Derby Street Hingham, MA 02043, USA Library of Congress Cataloging in Publication Data Main entry under title: Organ preservation. Includes index. 1. Preservation of organs, tissues, etc. I. Pegg, David Edward. II. Jacobsen, I. A. III. Halasz, N.A. IV. Transplantation Society. [DNLM: 1. Tissue preservation-Methods-Congresses. WO 665068 1981] RD129.07 617'.95 82-15235 ISBN-13: 978-94-011-6269-2 AACR2 Copyright © 1982 MTP Press Limited Softcover reprint of the hardcover 1s t edition 1982 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior permission from the publishers. Typeset1ing by Georgia Origination, Liverpool Contents Preface xi List of Contributors xiii I. BASIC REVIEWS 1 Energetics and mitochondria 3 H. Feinberg 2 Membrane functions 17 M. J. Pringle 3 Biological significance and therapeutic potential of prosta- cyclin 27 S. Moncada and J. R. Vane 4 A free radical approach to tissue injury 33 H. H. Thaw, J. O. Forsberg, R. F. Del Maestro, B. Gerdin, F. N. McKenzie and K. -E. Arfors 5 Endothelial cell function and organ preservation ex vivo 43 J. D. Pearson, A. Hutchings and J. L. Gordon 6 The principles of organ storage procedures 55 D. E. Pegg II. EFFECTS OF ISCHAEMIA AND ANOXIA 67 7 Recovery of renal function in the rat after warm ischaemia: functional and morphological changes. 69 V. Marshall, P. Jablonski, B. Howden, E. Leslie, D. Rae and J. Tange 8 The dynamics of regional blood flow after ischaemic trauma of the rat kidn~y 77 L. Fr6din, L. Kar/berg, O. Kiillskog, B. J. Nor/en and M. Wolgast 9 Renal function impairment in swelling with and without anoxia 83 J. Jamart and L. Lambotte ORGAN PRESERVATION 10 Prostacyclin and the ischaemic kidney 91 A. R. Mundy, J. M. Restorick and M. Bewick 11 Kidney blood flow and microcirculatory changes after autologous kidney transplantation 97 H. Wilms and E. Sinagowitz III. BIOCHEMICAL AND PHARMACOLOGICAL ASPECTS OF HYPOTHERMIA 101 1 2 Future prospects in organ preservation 103 B.D. Ross 13 Tissue pH changes in renal preservation 104 P. Sehr, P. J. Bore, K. Thulborn, I. Papatheofanis, L. Chan and G. K. Radda 14 Study of human kidneys prior to transplantation by phosphorus nuclear magnetic resonance 11 3 L. Chan, M. E. French, D. G. Gadian, P. J. Morris, G. K. Radda, P. J. Bore, B. D. Ross and P. Styles 1 5 Effects of hypothermia on anabolic and catabolic processes and on oxygen consumption in perfused rat livers 1 21 F. A. Zimmermann, H. G. Dietz, Ch. O. Kohler, N. Kilian, J. Kosterhon and R. Scholz 16 Mechanism of loss of mitochondrial functions during hypothermic storage of kidneys 127 J. H. Southard, R. M. Hoffmann and F. O. Belzer 17 Depletion of CoA in dog kidneys during hypothermic perfusion 133 S. Skrede, G. Lande, O. Slaattelid and A. Flatmark 18 Renal viability testing during preservation by metabolic parameters 139 J. H. Fischer, I. Hansen-Schmidt, D. Kulus and W. Isselhard 1 9 Hibernatory animals as a model for hypothermic organ preservation 147 C. J. Green, B. D. Ross, B. J. Fuller, J. T. Brosnan, M. Lowry, M. Stubbs and E. Shoebridge 20 Pharmacological factors in organ preservation 1 51 N.A. Halasz 21 Effect of chlorpromazine on the contractile function and metabolic status of continuously perfused and ischaemic hearts 161 G. E. Thomas, S. Levitsky and H. Feinberg vi CONTENTS IV. PRESERVATION BY INITIAL PERFUSION AND HYPO- THERMIA 165 22 Flush preservation 167 G. M. Collins 23 The effect of cooling rate in flush preservation of rabbit ~dneys 179 I. A. Jacobsen, J. Chemnitz and E. Kemp 24 Washout of red blood cells from kidneys damaged by warm ischaemia 183 J. Foreman, M. C. Wusteman and D. E. Pegg 25 Comparative evaluation of a new low ionic strength, hyperkalaemic flush solution 187 G. M. Collins, N. A. Halasz and G. M. Fahy 26 Hypothermic preservation of the rat pancreas 191 J. Klempnauer, D. E. Pegg, M. J. Taylor and M. P. Diaper 27 Deuterium oxide (020) for organ preservation 199 J. H. Fischer, G. Reifferscheidt, M. Fuhs, M. Wenzel and W. Isseih ard 28 Retrograde oxygen persufflation - a technique for preserv- ation of ischaemically damaged organs 205 J. H. Fischer and W. Isselhard V. PRESERVATION BY CONTINUOUS PERFUSION 213 29 Kidney preservation by continuous perfusion 21 5 R. W. G. Johnson 30 Continuous perfusion and transplantation of rat kidneys 225 T. Andreen, D. Fr6din and B. Harvig 31 Cold storage and machine preservation of kidney: studies with the isolated rat kidney 231 V. Marshall, P. Jablonski, B. Howden, E. Leslie, D. Rae and D. F. Scott 32 Light microscopy findings in intermediate term kidney preservation 239 J. van der Wijk, C. Voordes, B. G. Rijkmans and G. Kootstra 33 Five-day preservation of canine kidneys using a preservation machine 245 A. Ozaki, K. Fukao, M. Sano, T. Okamura and Y. Iwasaki vii ORGAN PRESERVATION 34 Lysosomal enzyme release during successful 5-, 7- and 8-day canine kidney storage 249 G. L. Cohen, F. IN. Ballardie, A. Mainwaring and R. W. G. Johnson 35 Aerobic and anaerobic perfusion of canine kidneys with a new perfusate 253 F. O. Belzer, R. M. Hoffmann and J. H. Southard 36 The use of oncotic support agents in perfusion preservation 261 R. M. Hoffmann, J. H. Southard and F. o. Belzer 37 Intermediate ex-vivo and in-vitro perfusion to prolong hypothermic kidney preservation up to 6 days 267 B. G. Rijkmans, G. Kootstra, J. Van der Wijk and A. Nizet 38 Is normothermic preservation an alternative to hypothermic preservation? 273 R. N. Dunn, F. K. Merkel, D. Roseman, M. Haklin and K. English 39 Measurement of tissue Po2 during kidney perfusion with Fluosol®-43 279 O. Ruland, U. Spiegel, J. Hauss, K. Schonleben and H. Themann 40 Liver preservation in the rat 283 N. Kamada, R. Y. CaIne, D. G. D. Wight and B. J. Roser 41 The effect of donor pretreatment on tubular function of the preserved canine allograft 287 A. Swistel, D. Lorieo and R. McCabe 42 Xenobanking 291 E. Kemp, G. Kemp, S. Larsen, H. Starklint and C. J. Green VI. PRESERVATION OF CADAVER KIDNEYS 303 43 Factors influencing primary function in kidney transplants from brain-dead donors 305 H. Bondevik, A. Jakobsen and A. Flatmark 44 Can immediate function of a cadaver renal transplant be predicted? 307 A. T. Raftery, L. Hunt, S. B. Lucas and R. W. G. Johnson 45 Factors of consequence for graft survival: a statistical analysis 309 H. E. Jorgensen, S. Kreiner, M. Larsen, L. R. Poulsen and S. Walter viii CONTENTS 46 Early and long-term function of cadaveric kidneys preserved by ice storage after flushing with Collins' solution 31 3 I. R. Hardie and G. A. Balderson 47 The effect of dopamine administered to kidney graft recip- ients 315 R. Grundmann VII. GENERAL DISCUSSION 321 48 Pretreatment 323 49 Initial perfusion 325 50 Hypothermic preservation 329 51 Experimental models 351 VIII. CRYOPRESERVATION 361 52 Perfusion of canine kidneys with dimethyl sulphoxide; techniques and toxicity 363 I. R. Hardie, L. B. Hamlyn, G. A. Balderson, K. L. Gall and P. W. H. Woodruff 53 Prevention of toxicity from high concentrations of cryo- protective agents 367 G.M. Fahy 54 Kidney preservation with Me2S0- and sucrose-containing solutions 371 R. Grundmann and K. Kurten 55 Investigation into subzero non-freezing storage of rabbit ~dney 377 D. R. Osborne, B. J. Fuller, G. R. Atkins, V. D. Attenburrow, L. H. Nutt and K. E. F. Hobbs 56 Survival of hepatocytes upon thawing from - 196°C: functional assessment after transplantation 381 B. J. Fuller, R. J. Woods, L. H. Nutt and V. D. Attenburrow 57 The effect of cryoprotectant concentration on freezing damage in kidney slices G.M. Fahy 58 The mechanism of cryoinjury in glycerol-treated rabbit kidneys 389 D. E. Pegg and M. P. Diaper ix ORGAN PRESERVATION 59 Rabbit kidney function in vitro following cooling to - 20°C with glycerol or dimethyl sulphoxide 395 F. M. Guttman, J. Borzone and N. B. Segal 60 Prospects for organ preservation by vitrification 399 G. M. Fahy and A. Hirsch 61 General discussion of cryopreservation 405 Index 423 x Preface During the past 10 years, there have been many international meetings on the storage of organs prior to transplantation, and several have led to the publication of proceedings; there have also been a number of other books on this subject-. Most of these publications have concentrated on practical clinical aspects of organ preservation and on empirical animal experiments directed towards well-defined clinical objectives. Progress was rapid at first, but it is now generally agreed that there has been little improvement in techniques during the past 5 years, although understanding has certainly increased. In 1980 the Tissue Preservation and Banking Committee of the Transplantation Society decided that a fresh approach to the problem of improving preservation methods was needed: it was decided to hold a conference at which an opportunity would be provided to return to basic principles and to examine some of the advances that have occurred in recent yelns in areas of physiology that might be important for further improvements in preservation. The conference was held in Cambridge, UK, in April 1981 and this book is based upon the papers presented to that meeting and the work of a small discussion group that met after the main meeting. The book starts with six basic review chapters, followed by sections on the effects of ischaemia and anoxia, and on biochemical and pharmacological aspects of hypothermia. Chapters dealing with organ preservation by initial perfusion followed by hypothermia, and by continuous hypothermic perfusion, follow. The preservation of cadaver kidneys in clinical practice is dealt with in five concise contributions, and the book concludes with a section describing recent attempts to develop cryopreservation techniques for whole organs. At the conference, each of these subjects was discussed by a group of approximately forty participants in the one-and-a-half days that followed the main conference, and an edited transcript of their discussions is also included. The meeting could not have been held without the financial support of the following: American Hospital Supply (UK) Ltd; Burroughs Wellcome Fund; Cordis Corporation; Fogarty International Center; National Institutes of Health; W. L. Gore & Associates (UK) Limited; Imperial Chemical Industries; Sandoz Limited; Smith, Kline and French; Surgical Education and Research Foundation, San Diego; Upjohn Limited; and Wellcome Research Laboratories. Gambro provided a generous donation to defray the cost of publication. To these organizations the xi
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