Elsevier

Transplantation Proceedings

Volume 37, Issue 1, January–February 2005, Pages 308-311
Transplantation Proceedings

Kidney preservation with IGL-1 solution: A preliminary report

https://doi.org/10.1016/j.transproceed.2004.12.045Get rights and content

Abstract

The University of Wisconsin (UW) solution is the most commonly used preservation solution. However, a new preservation solution—IGL-1—contains an inversion of K and Na concentrations and substitution of polyethylene glycol for hydroxyethyl starch in the UW solution. The present study is the first clinical experience on the outcome of kidneys preserved in IGL-1 solution. From June 2003 to June 2004, 119 cadaveric kidneys were retrieved and stored in IGL-1 solutions; among the 119 organs, this study includes 37 IGL-1-preserved kidneys that were locally transplanted versus 33 kidneys stored in University of Wisconsin (UW) solution that were also locally transplanted. The groups were comparable with regard to donor and recipient characteristics. Renal function outcome was evaluated by comparing delayed graft function (DGF) rates, the evolution of serum creatinine, daily urine output, and creatinine clearance. Biopsies were performed after reperfusion to evaluate apoptosis. The incidence of DGF was 5.71% among IGL-1 kidneys and 13.79% among UW kidneys. Creatinine values were significantly lower among the IGL-1 group from 2 to 14 days postoperative and at 1 month. Daily urinary output did not show any significant differences between the two groups. IGL-1 kidneys had a superior creatinine clearance during the first 15 postoperative days compared to UW kidneys. Kidneys preserved in IGL-1 solution showed fewer apoptotic cells compared to kidneys preserved in UW solution. This preliminary report suggests a superiority of IGL-1 for the immediate outcome of transplanted kidneys.

Section snippets

Materials and methods

From June 27, 2003, until June 30, 2004, 119 cadaveric kidneys were retrieved and stored in IGL-1 solution. Among these 119 organs, 48 were locally transplanted while the other kidneys were exported to other French centers as a result of exchange activities within “Etablissement Français des Greffes” organization.

This first clinical study compares 37 IGL-1-preserved kidneys that were locally transplanted with 33 kidneys stored in UW solution and transplanted between August 27, 2002, and

Results

Figure 1 illustrates the evolution of serum creatinine during the first 15 postoperative days. Creatinine values were significantly lower among the IGL-1 group from 2 to 14 days after transplantation. At 1 month posttransplantation the serum creatinines were 124.72 mmol/L and 105.17 mmol/L in UW and IGL-1 kidneys (P = .030), although they were not significantly different at 3, 6, or 12 months.

Daily urinary output did not show any significant difference between the two groups. Compared to UW

Discussion

The present study sought to compare IGL-1 versus UW solution for protection of the kidney grafts against cold ischemic storage and reperfusion injuries. IGL-1 solution, which is characterized by high Na concentration and PEG 35 substitution for HES, was previously tested in an isolated perfused rat kidney model and in a pig kidney autotransplant model.7 The experimental studies demonstrated that the inversion of K+ and Na+ concentrations leads to an improved fractional sodium reabsorption and

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