Improved preservation of warm ischemia-damaged porcine kidneys after cold storage in Ecosol, a novel preservation solution.

BACKGROUND: Ecosol, an extracellular-type, colloid-based preservation solution, has recently been introduced for washout, cold storage, and machine perfusion preservation of kidney grafts. Here, we assessed the efficacy of Ecosol compared to the widely used Histidine-Tryptophan-Ketoglutarate solution (HTK) for 24-h cold storage preservation of warm ischemia-damaged kidney grafts. MATERIAL AND METHODS: Before recovery, warm ischemia was induced by clamping the renal pedicle for 45-min. Thereafter, kidneys were washed-out and cold-stored for 24-h in Ecosol or HTK solution. Kidneys recovered without warm ischemia and cold-stored for 24-h in HTK served as controls (n=5). Renal function and damage parameters were assessed during 1-h normothermic reperfusion using the isolated perfused porcine kidney model. RESULTS: Renal function did not differ between Ecosol and controls and was significantly reduced in HTK compared to controls. Total output of urine was higher in Ecosol compared to HTK. Intrarenal resistance and urine protein concentrations in Ecosol were lower compared to HTK and equal to controls. In the Ecosol group, oxygen consumption during reperfusion was higher and reduced tissue lipid peroxidation products were detected compared to HTK. CONCLUSIONS: The preservation quality of warm ischemia-damaged, cold-stored porcine kidneys was improved using the recently developed Ecosol preservation solution compared to HTK.