TRANSPLANTATION OF KIDNEYS DONATED FROM THE USA - LONG-TERM RESULTS AND VIABILITY TESTING USING P-31-MRS

Since June 1983, 27 kidneys have been shipped to the Kidney Center at the Tokyo Women's Medical College (TWMC) from the United States. These organs were divided into two groups, based on the years of their dona tion; 13 kidneys were assigned to group 1 and 14 to group 2. The diffe rences between the two groups were as follows: donor age 19.8 +/- 10.0 years vs 51.9 +/- 14.5 years in group 2 (P < 0.0001); total ischemic time 42 h 12 min in group 1 vs 65 h 42 min in group 2 (P = 0.0002); an d Euro-Collins preservation solution in group 1 vs University of Wisco nsin (UW) solution in group 2. One hundred percent of the kidneys in g roup 1 and 85.7 % of those in group 2 recovered their function. The lo west serum creatinine levels averaged 96 +/- 38.4 mu mol/l and 185.8 /- 101.0 mu mol/l, respectively (P = 0.01). The viability of 9 out of 14 grafts in group 2 were tested using P-31 magnetic resonance spectro scopy (P-31-MRS). The results showed that all of the grafts having a m onophosphate/inorganic phosphate (MP/Pi) ratio higher than 0.3 recover ed their function and those lower than 0.2 did not. The problems assoc iated with international organ sharing are discussed, along with the d ifficulties encountered at TWMC.