We hypothesize that the sudden warm reperfusion after Cold Storage [CS] is detrimental for the graft and we therefore evaluated different warming-up procedures before reperfusion.

Methods:

Rat left kidneys [n=8 per group] were retrieved and stored in University of Wisconsin solution for 24 hours at 4°C followed by immediate reperfusion at 38 °C or gradually warming up to 10°C , 25°C or 38°C, using an isolated perfused kidney [IPK]. Renal function and renal injury were assessed during 90 minutes of the perfusion.

Results:

The increases in the injury biomarkers such as aspartate transaminase and lactate dehydrogenase in the perfusate were lower in the gradual warming up groups vs the control group. KIM-1, HSP-70, ICAM-1, VCAM-1 expression were decreased in the 10°C and 25°C groups. Sodium re-absorption was improved in the gradual warming up groups and reached significance in the 25°C group after 90 minutes of perfusion.

Conclusion:

After a period of CS, kidneys objected to gradual warming up suffer less renal parenchymal and tubular injury and demonstrate better endothelial preservation. This study suggests that gradual warming up after CS is beneficial compared to immediate reperfusion at body temperature.

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