THE SHOCK-WAVE INDUCED VESSEL LESION IN T HE EX-VIVO MODEL OF THE ISOLATED-PERFUSED KIDNEY

Little is known about the mechanism and determining parameters of shoc k wave induced kidney trauma. After classification of the renal lesion in the in-vivo canine model, we developed an ex-vivo model using the isolated perfused kidney of the pig that avoids unpredictable artefact s and can be standardized. Kidneys from slaughtered pigs were isolated and perfused by tyrode solution under physiological conditions. After shock wave application on the Modulith SL 20 the vessel lesions were evaluated by means of microangiography with respect to size and freque ncy of dye paravasation in the different regions of the organ. The inf luence of focusal localization within the kidney (capsule, cortex, cor tico-medullar border, medulla-sinus), of the shock wave dosis (number of shock waves, generator voltage) and of the perfusate (tyrode soluti on, bariumsulphate suspension) were examined. Variations in focus loca lization caused different patterns of lesions which characterized the pathway of the shock wave. In particular, constant petechial paravasat ion in the cortex was observed. Generator voltage correlated with the diameter and frequency of the lesion area. The number of shock waves p rimarily influenced the frequency of vessel rupture. In conclusion, it was possible to evaluate localization and dose-dependency of the shoc k wave-induced kidney trauma with high sensitivity and reproducibility . Further advantages of the model are its easy availability and the fa ct that studies on living animals are unnecessary. Thus, standardizati on and comparison of different lithotripters become possible.