GLOMERULAR DAMAGE AFTER KIDNEY PRESERVATION

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Abstract
Severe proteinuria occurs during isolated organ perfusion of kidneys removed from SD and DA rats and subjected to 24-hr cold preservation. In both strains increased glomerular permeability was associated with changes in glomerular visceral epithelial cells, particulary cytoplasmic edema and detachment of cells from capillary basement membranes. Foot processes were intact and staining for sialoglycoprotein was retained. The changes were compatible with survival of the isograft kidney after transplantation, but moderate proteinuria was found in some rats after one month. Protein loss in the urine during isolated organ perfusion is very much less in kidneys subjected to 4-hr cold preservation, and the glomerular epithelial cells are normal or show only minimal cytoplasmic edema on electron microscopy. Th;e experiment shows that significant damage to glemeruli may occur during preservation prior to transplantation, and the model itself can be usefully exploited to determine the relation between increased glomerular permeability to albumin and the associated changes in the glomerular capillary wall.