Donor treatment with phentolamine mesylate improves machine preservation dynamics and early renal allograft function

Background It has been suggested that pharmacologic conditioning of the don or before organ procurement may protect the renal allograft from injuries a ssociated with the cold ischemic period. We compared the administration of two vasoactive agents before organ procurement to: (1) determine their infl uence on machine perfusion characteristics and (2) determine their impact o n delayed graft function (DGF) in transplanted renal allografts. Methods. Between January 1997 and December 1998, 150 kidneys were procured from heart-beating donors and preserved in our laboratory by machine perfus ion (IMP) or cold storage (CS). The following vasoactive agents were random ly administered to the donor 5 min before aortic cross clamp: phentolamine mesylate (PM) or hydralazine (II), The control groups received no donor con ditioning, Kidneys were grouped as follows: (1) MP+PM, (2) MP+H, (3) MP, (4 ) CS+PM, (5) CS+H, (6) CS, 10 mg PM/50 kg donor weight was administered to the PM groups and 20 mg H/50 kg donor weight was administered to the H grou ps. DGF was defined as the need for dialysis within the first 7 days after the transplant, Results. MP+PM increased renal flow by 12% and decreased renal resistance b y 18% compared with the RIPS H group, and increased renal flow by 23% and d ecreased renal resistance ky 30% compared with the IMP group. Moreover, the MP+PM group was associated with improved early allograft function. Conclusions, Donor treatment with PM immediately before aortic cross-clamp is associated with improved machine perfusion dynamics (renal flow and rena l resistance) and lower incidence of DGF compared with donor treatment with H or no treatment. Moreover, MP of renal allografts was associated with im proved early function compared with CS grafts.