TY - JOUR
T1 - Evaluating the effects of extended cold ischemia on interstitial metabolite in grafts in kidney transplantation using microdialysis
AU - Fonouni, Hamidreza
AU - Jarahian, Parvin
AU - Rad, Morva Tahmasbi
AU - Golriz, Mohammad
AU - Faridar, Alireza
AU - Esmaeilzadeh, Majid
AU - Hafezi, Mohammadreza
AU - MacHer-Goeppinger, Stephan
AU - Longerich, Thomas
AU - Orakcioglu, Berk
AU - Sakowitz, Oliver W.
AU - Garoussi, Camelia
AU - Mehrabi, Arianeb
N1 - Funding Information:
Acknowledgments We are very grateful that this work has been supported by a grant of “Heidelberger Stiftung Chirurgie”. We also appreciate the kind support of Mrs. Shadi Jafarieh during the preparation of this article.
Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2013/1
Y1 - 2013/1
N2 - Purpose: During kidney transplantation (KTx), the length of cold ischemia time (CIT) and the subsequent changes in energy metabolism may lead to variations in interstitial metabolites. Using microdialysis (MD), we evaluated the effects of a short and long CIT on changes of these metabolites. Methods: Sixteen pigs were randomized in two identical groups, one with a short CIT and the other one with a long CIT. Using MD in the transplanted grafts, we evaluated the parenchyma concentrations of glucose, lactate, pyruvate, glutamate and glycerol in different stages. Results: We noted that during the warm ischemia time (WIT) and in the early post-reperfusion phase glucose levels increased more significantly in the long CIT group and remained high until the end of monitoring. At the end of CIT and during WIT, the long CIT group had a significantly higher glycerol level, but the level dropped gradually in the late post-reperfusion phase and reached a steady state in both groups. Conclusions: The extended CIT clearly results in considerably impaired graft metabolism. The high interstitial glucose levels within hours after KTx could be considered as a marker of primary delayed function of the graft. Furthermore, the glycerol value could reflect the extent of graft injury during the ischemia time or in case of acute impairment of graft perfusion.
AB - Purpose: During kidney transplantation (KTx), the length of cold ischemia time (CIT) and the subsequent changes in energy metabolism may lead to variations in interstitial metabolites. Using microdialysis (MD), we evaluated the effects of a short and long CIT on changes of these metabolites. Methods: Sixteen pigs were randomized in two identical groups, one with a short CIT and the other one with a long CIT. Using MD in the transplanted grafts, we evaluated the parenchyma concentrations of glucose, lactate, pyruvate, glutamate and glycerol in different stages. Results: We noted that during the warm ischemia time (WIT) and in the early post-reperfusion phase glucose levels increased more significantly in the long CIT group and remained high until the end of monitoring. At the end of CIT and during WIT, the long CIT group had a significantly higher glycerol level, but the level dropped gradually in the late post-reperfusion phase and reached a steady state in both groups. Conclusions: The extended CIT clearly results in considerably impaired graft metabolism. The high interstitial glucose levels within hours after KTx could be considered as a marker of primary delayed function of the graft. Furthermore, the glycerol value could reflect the extent of graft injury during the ischemia time or in case of acute impairment of graft perfusion.
KW - Cold ischemia time
KW - Kidney transplantation
KW - Metabolic changes
KW - Microdialysis
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U2 - 10.1007/s00423-012-1010-0
DO - 10.1007/s00423-012-1010-0
M3 - Article
C2 - 23070477
AN - SCOPUS:84871785179
SN - 1435-2443
VL - 398
SP - 87
EP - 97
JO - Langenbeck's Archives of Surgery
JF - Langenbeck's Archives of Surgery
IS - 1
ER -