EX-VIVO RESUSCITATION OF KIDNEYS AFTER POSTMORTEM WARM ISCHEMIA

An ex vivo resuscitation of kidney function following substantial post mortem warm ischemia was attempted with the ultimate goal of overcomi ng the ischemic barriers in organ retrieval for transplantation. The r esuscitation technology involved reperfusion at 32 degrees C with an a cellular solution to reinstitute oxidative metabolism of sufficient ma gnitude to restore function after a substantial postmortem warm ischem ic insult. The ability to resuscitate renal function at various time p eriods postmortem was evaluated. Resuscitation parameters included per fusion pressures, vascular flow rates, vascular resistances, restorati on of diuresis with concordant urinary creatinine concentrations, and blinded histologic evaluations. The results of this study suggest that it may one day be feasible to resuscitate organs following as much as 2 hr of postmortem warm ischemia for clinical transplantation. An exp anded donor pool consisting of allografts resuscitated post mortem fro m what is now considered to be the ''non retrieval donor'' could help alleviate the chronic organ shortage. Furthermore, since organs resusc itated ex vivo at 32 degrees C exhibited ongoing metabolism, which was artificially supported rather than inhibited by traditional hypotherm ia, diuresis was restored. The ability to collect and analyze urine du ring organ resuscitation and preservation may present the opportunity to assess organ function prospectively.