Supercooling, intermittent perfusion, and high pressure oxygen in whole organ preservation.

Abstract

Renal function adequate to sustain life for one year will return in canine kidneys stored for 24 hr at +2 C. and 3 atmos (absolute) of pressure (100% 02) provided that prior to performing a contralateral nephrectomy, two to three weeks are allowed for reversal of damage incurred during storage. Ileal segments stored in a similar fashion remain viable and actively absorb glucose. Increasing the pressure of oxygen from 3 to 8 and 15 atmos and intermittently perfusing the organs with a cell-free perfusate that is exposed to the hyperbaric, hypothermic environment have not proven valuable adjuncts in organ preservation. Supercooling with 10% dimethylsulfoxide in a hyperbaric environment permits preservation of renal function but of poorer quality than with hypothermia at +2 C. The currently available methods of organ preservation all incur some degree of histologic and functional damage, some of which is reversible. Adequacy of function in the successfully preserved organs frequently cannot be predicted from the histology. All of the dogs living for one year with preserved kidneys are hypertensive.