Abstract

You have accessJournal of UrologyCME1 Apr 2023PD31-06 THE EFFECT OF KIDNEY PRESERVATION AT 10°C WITH HEMOPURE AND HYDROGEN SULFIDE DONOR, SODIUM THIOSULFATE, IN A SYNGENEIC RAT RENAL TRANSPLANTATION MODEL Maria Abou Taka and Alp Sener Maria Abou TakaMaria Abou Taka More articles by this author and Alp SenerAlp Sener More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003324.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Renal transplantation is the preferred treatment for patients with end-stage renal disease. Yet, donor kidney demand outweighs supply. Static cold storage (SCS) at 4°C is the current gold standard for renal preservation. SCS contributes to kidney damage through renal ischemia-reperfusion injury (IRI) that involves cellular death and inflammation. In porcine models of renal transplantation, we added non-FDA-approved hydrogen sulfide (H2S) donor, AP39, to a bovine-based blood substitute, Hemopure, at 21°C and 37°C, which improved renal graft quality; though, the experimental setup was costly to meet renal metabolic demand. In rats, we investigated sodium thiosulfate (STS), an FDA-approved H2S donor, at 4°C and observed similar benefits. However, there is still a risk of 4°C cold IRI. Recent studies showed that 10°C human organ graft preservation enhanced patient survival without requiring extensive oxygen during preservation. Therefore, we hypothesize that preservation solutions with STS and Hemopure at 10°C will reduce renal IRI compared to SCS. METHODS: Using an in vitro model of rat renal IRI, we evaluated STS use at 4°C, 10°C, 21°C, and 37°C. We treated rat proximal tubular epithelial cells with 150 µM STS for 24 hours in hypoxic conditions to mimic ischemia, and 24 hours in normoxic conditions to mimic reperfusion. To assess cellular viability, we used flow cytometry and stained cells with FITC-Annexin-V and PerCP-Propidium Iodide to determine apoptosis and necrosis levels, respectively. RESULTS: STS treatment significantly enhanced cellular viability at 10°C compared to 4°C, 21°C, and 37°C, as determined by the percentage of cells negatively stained with FITC-Annexin-V and PerCP-Propidium Iodide. STS treatment also significantly decreased apoptotic and necrotic cells at 10°C compared to 4°C, 21°C, and 37°C, as shown by the percentage of cells positively stained with FITC-Annexin-V and PerCP-Propidium Iodide. CONCLUSIONS: Overall, 10°C STS treatment significantly protects rat proximal tubular epithelial cells from IRI, suggesting that 10°C kidney preservation may enhance renal graft survival, especially in a cost-effective manner, compared to other preservation temperatures currently used in transplantation. Source of Funding: Ontario Graduate Scholarship, Department of Surgery Internal Research Funds, Lawson Internal Research Fund © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e902 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maria Abou Taka More articles by this author Alp Sener More articles by this author Expand All Advertisement PDF downloadLoading ...

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