The effect of ischaemic injury on kidneys preserved for 24 hours before transplantation

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Abstract
Kidneys have been preserved for 24 hours by three methods–continuous hypothermic perfusion with plasma protein fraction (P.P.F.), simple ice storage using the method of Collins, Bravo-Shugarman, and Terasaki (1969), and a combination of simple ice storage followed by continuous perfusion. Prior to preservation the kidneys were subjected to warm ischaemic intervals varying from 0 to 180 minutes. Kidneys preserved without warm ischaemia functioned immediately whichever method was used. Kidneys preserved by perfusion after up to 60 minutes of warm ischamia returned to normal function; kidneys preserved by Collins's method did not function after ischaemic injury. The period of storage of ischaemically injured kidneys initially preserved by Collins's method can be extended to 24 hours by subsequent continuous perfusion, but the results are not as good as with perfusion alone. A fall in perfusate pH was a reliable indication that kidneys would not function after 24 hours' storage.