RESULTS OF KIDNEY-FUNCTION AFTER TRANSPLANTATION UNDER PROTECTION WITH EURO-COLLINS, UW OR HTK SOLUTION

Until 3 years ago mainly the Euro-Collins (EC) solution was used by th e transplant centers. First experimentally and then also clinically th e HTK (Histidine-Tryptophane-Ketoglutarate) solution of Bretschneider and the UW (University of Wisconsin) solution were introduced. The ini tial kidney-function after EC protection was not satisfying, the early diagnosis of transplant rejection at initial nonfunctioning (ATN) was difficult. The aim of our study was to investigate the three solution s on the basis of postischemic kidney function. Parameters were the se rum creatinine, the creatinine clearance, the fractional sodium excret ion and the free water clearance. All parameters were measured from 24 -hours urine samples. The follow up was 30 days. Mean cold ischemic ti me was 26 hours in the EC group (n = 18), 25 hours in the UW group (n = 17) and 21 hours in the HTK group (n = 24). The time for vascular an astomosis was in all groups approximately 25 minutes. Donor age was in the UW group 32 years, in the EC group 42 years and in the HTK group 39 years. Age of recipients was similar in the 3 groups. The frequency of rejections was 55% (EC), 41% (UW) and 33% (HTK).The rate of second ary function was 20,8% (HTK), 23,5% (UW) and 27,7% (EC). The postopera tive serum creatinine levels were in the EC group during the first 3 w eeks about 1 mg% higher than in the other groups. After 3 weeks serum creatinine levels were in all groups between 2-2.5 mg%. The creatinine clearance increased in the EC group from 20 ml/min to almost 40 ml/mi n, in the UW group initially to 60 ml/min and down again to 40 ml/min. Creatinine clearance in HTK kidneys rose from 30 ml/min to 50 ml/min. After 3-5 days the FE(sodium), for evaluation of proximal tubulus fun ction, was 10% in the EC group, 4% in the UW group and 3% in the HTK g roup. The free water clearance, for measuring concentration ability, w as -0,5 ml/min in the EC group, in the UW and HTK group between -0,5 t o -1,0 ml/min. The use of EC solution leeds to an inferior kidney func tion when compared to UW or HTK solution both in respect to glomerular filtration rate and tubular function. HTK protection leads to a const ant increase of the creatinine clearance (gfr) compared to the UW prot ection and has the highest primary function rate even though the donor age was higher than in the UW group.