Analysis of Interactions Between Components of Selected Solution for Organ Perfusion and Preservation.

BACKGROUND: In the literature there is a great deal of information about the activity of liquid preservatives and the solutions used to modify them; however, there is no information about the possibility of interactions between them during multiorgan retrieval. The aim of the study was to analyze the possibility of reactions between the components of Biolasol and histidine-tryptophan-ketoglutarate (HTK). Biolasol is the first Polish liquid preservative intended for rinsing kidneys, livers, and pancreases by simple hypothermia. HTK is a cardioplegic fluid used in organ preservation of hearts, livers, kidneys, pancreases, and lungs. METHODS: Biolasol and HTK solution were used for the tests. The preservatives were mixed together at 1:1, 0.25:0.75, and 0.75:0.25 ratios. The volume of mixtures to be analyzed was 500 mL. The prepared systems were stored in a refrigerator (4°C) protecting against light. The systems were subjected to physicochemical analysis involving pH, density, viscosity, buffer capacity, osmolarity, and absorbance measurements as well as visual and microscopic assessment at time intervals: immediately after mixing (t = 0) and after 12, 24, 48, and 72 hours. RESULTS: The analysis suggests that interactions between solution components can occur and have a positive effect on storage time and effectiveness of organ rinsing. CONCLUSIONS: The use of Biolasol and HTK in multiorgan retrieval is safe.

Toll-like receptors 2 and 4 in pigs' kidneys early after autotransplantation procedure.

OBJECTIVES: The aim of this paper was to evaluate mRNA expression of Toll-like receptors 2 (TLR2) and 4 (TLR4) and the adaptor protein myeloid differentiation primary-response protein 88 (MyD88) in pigs' kidneys 14 and 30 days after autotransplantation. METHODS: The research was conducted on 12 animals that underwent left renal transplantation procedure with further standardized rinsing with Biolasol solution and 24 hours' storage in 4°C; subsequently the kidneys were implanted in the right retroperitoneal space after right-side nephrectomy. Six randomly chosen animals (group I) were under observation for 14 days, the other 6 (group II) for 30 days. After these observation periods, the animals were killed and 4-g samples were collected from the renal cortex and medulla. RESULTS: Expression of mRNA in homogenates of collected samples were determined with the use of reverse-transcription polymerase chain reaction analysis. Obtained results in both groups, presented in relation to GAPDH, were compared with the use of Mann-Whitney U test. Stable graft function was observed in all animals from the 2nd day after the procedure. TLR2 in group I reached the mean value of 3.64 and was statistically significantly higher than in group II (2.19). Inverse proportion was observed in case of mRNA for TLR4: group II presented 2 times higher value than group I (0.25 vs 0.11). Similarly, significant difference was observed in MyD88 (group I, 0.067; group II, 0.45). CONCLUSIONS: At 14 days after autotransplantation of a pig kidney, mRNA expression for TLR2 is dominant; later, expression increases for TLR4 and MyD88.

The effect of HTK solution modification by addition of thyrotropin and corticotropin on biochemical indices reflecting ischemic damage to porcine kidney.

INTRODUCTION: The aim of our study was to evaluate the impact of perfusion with HTK (histidine-tryptophan-ketoglutarate, Custodiol®, Dr. Franz Kohler Chemie, Germany) solution, modified by the addition of porcine thyroid-stimulating hormone (TSH) and corticotropin (ACTH), on selected biochemical parameters of porcine renal damage within 24 and 48 hours after the onset of cold ischemia time. METHODS: Each study group consisted of 10 adult pigs. During harvesting the kidneys were rinsed with Ringer solution (group 1), HTK (group 2), HTK-TSH (1 µg/dL) or HTK-ACTH (1 µg/dL) in groups 3 and 4. The solutions were cooled to 4°C-6°C. Within 30 minutes of the first perfusion, the discharged fluid was clear and the kidneys cooled to 4°C. The levels of lactate dehydrogenase, asparagine and alanine aminotransferases, lactates, total protein, potassium, calcium, and pH were determined in the perfusate. After 24 and 48 hours the rinsing procedure and the above-mentioned tests were repeated. Differences between the means of 2 independent samples were tested with a nonparametric Mann-Whitney U test. RESULTS: As the result of hormone addition, in both time intervals it was possible to observe considerably lower protein concentrations (g/L) in perfusates compared with HTK solution, without an addition. At 24 hours, we measured following values: 36 ± 4, 8 ± 3 and 6 ± 1 versus 48 hours, 34 ± 1, 2 ± 1, and 4 ± 1 in groups 2, 3, and 4. A similar pattern was observed with LDH (U/L) at 48 hours: 662 ± 89, 374 ± 151, and 386 ± 111, respectively. Lactate concentrations (mmol/L) were then significantly higher: 1.4 ± 0.3 in the TSH group and 1.2 ± 0.5 in the ACTH group as opposed to 0.2 ± 0.1 in unmodified HTK group. CONCLUSION: We observed the possibility of cytoprotective actions of TSH and ACTH addition to the perfusion fluid during cold ischemia, positive effects that were especially visible upon prolonged 48-hour storage.

Hepatoprotective effect of prolactin and cysteine contained in perfusion and preservation solutions on porcine liver stored in simple hypothermia.

INTRODUCTION: The aim of our study was to determine the results of histidine-tryptophan-ketoglutarate (HTK) solutions modified by the addition of the antioxidant cysteine (Cys), and of prolactin (PRL) on storage of isolated porcine livers. METHODS: We measured in the media of isolated livers stored for 24 hours in HTK (control group) or modified HTK+Cys (0.3 mmol/L)+PRL (3 IU/L study group) the amounts of aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), lactic acid as well as Ca (II), Mg (II), Na (I) and K (I) ions during a 30-minute perfusion after 24 hours of storage. RESULTS: All tested markers were released more slowly into HTK+Cys+PRL with less release of K(I) and Mg(II) and greater of Na(I) and Ca(II) ions. CONCLUSIONS: Addition of the Cys and PRL to HTK positively affected 24-hour storage of isolated livers.

The effect of HTK solution modification by addition of prolactin on biochemical indices reflecting ischaemic damage to porcine kidney.

INTRODUCTION: The aim of our study was to evaluate the impact of perfusion with HTK solution, modified by the addition of prolactin (PRI), on selected biochemical parameters of porcine renal damage within 24 and 48 hours after the onset of cold ischemia time. METHODS: Each study group consisted of 10 adult pigs. During harvesting the kidneys were rinsed with Ringer's solution (group 1), HTK (group 2), and HTK+PRL in a dose of 0.2 mg/dL, 0.02 mg/dL, and 0.01 mg/dL in groups 3, 4 and 5, respectively. The levels of lactate dehydrogenase, asparagine (AST) and alanine aminotransferases, lactates, total protein, potassium and calcium were determined in the perfusate. After 24 and 48 hours the rinsing procedure and the abovementioned tests were repeated. RESULTS: After 24 hours of storage, in 4 groups, significantly lower levels of LDH (U/L) were recorded compared with HTK solution alone, namely 235 ± 93 versus 271 ± 125 (perfusion minute, 0), and 55 ± 21 versus 125 ± 94 (30th minute). Similar behavior pattern was presented by AST (U/L) and potassium (mmol/L), and the results were 31 ± 8 versus 35 ± 12 and 16 ± 10 versus 29 ± 14, and 12 ± 3 versus 16 ± 3 and 10 ± 1 versus 13 ± 1, respectively. The changes described above were not observed in the 48th hour of reperfusion. CONCLUSION: Our study results indicate the possibility of cytoprotective action of PRL after adding it to the fluid perfusing kidneys during cold ischemia. This effect, observed after 24 hours of storage, was to a considerable extent dose dependent. In our experiment the effect was pronounced only at 0.02 mg/dL supply of PRL.