Evaluation of Normothermic Flush and Perfusion Techniques, Using a Novel Normothermic Preservation Solution, in an Isolated Porcine Haemoperfusion Model
thesisposted on 29.07.2010, 11:11 by Mark Kay
The basis of the work in this thesis is an assessment of renal preservation techniques. The first chapter comprises a review of the pathophysiology of ischaemic injury and the role of hypothermic preservation. In the second chapter a review of the various preservation solutions in use is presented as well as the constituents of preservation solutions. The role of the organ flush is then presented, comparing warm and cold flush. The effect of viscosity and pressure is then examined followed by a review of hypothermic and normothermic preservation methods. The five main experimental chapters are then presented as a series of papers. The first of these aimed to assess the rate of organ cooling during back-table flush using different preservation solutions. In this paper, porcine kidneys were flushed with UW or Soltran solution, and the perfusion rate and cooling of the kidney was assessed. The second paper follows on comparing organ cooling using either a cold flush or a warm flush followed by a cold flush to compare flush rates and cooling times. The third paper assesses different flush techniques using a novel normothermic preservation solution, AQIX® RS-I, to assess the optimal flush conditions and functional outcomes. The fourth paper compares functional results of AQIX with the more commonly used cold flush solutions, Soltran and University of Wisconsin solution. The final experiment assesses the effectivness of complete normothermic preservation using AQIX® RS-I. An isolated organ perfusion system using cardiopulmonary bypass equipment was used for normothermic preservation and as a surrogate for transplantation. Porcine kidneys were used throughout all experiments as large animal models best reflect the human condition.