The effect of HTK solution modification by addition of thyrotropin and corticotropin on biochemical indices reflecting ischemic damage to porcine kidney

摘要

Introduction: The aim of our study was to evaluate the impact of perfusion with HTK (histidine-tryptophan-ketoglutarate, Custodiol?, Dr. Franz Kohler Chemie, Germany) solution, modified by the addition of porcine thyroid-stimulating hormone (TSH) and corticotropin (ACTH), on selected biochemical parameters of porcine renal damage within 24 and 48 hours after the onset of cold ischemia time. Methods: Each study group consisted of 10 adult pigs. During harvesting the kidneys were rinsed with Ringer solution (group 1), HTK (group 2), HTK-TSH (1 μg/dL) or HTK-ACTH (1 μg/dL) in groups 3 and 4. The solutions were cooled to 4°C-6°C. Within 30 minutes of the first perfusion, the discharged fluid was clear and the kidneys cooled to 4°C. The levels of lactate dehydrogenase, asparagine and alanine aminotransferases, lactates, total protein, potassium, calcium, and pH were determined in the perfusate. After 24 and 48 hours the rinsing procedure and the above-mentioned tests were repeated. Differences between the means of 2 independent samples were tested with a nonparametric Mann-Whitney U test. Results: As the result of hormone addition, in both time intervals it was possible to observe considerably lower protein concentrations (g/L) in perfusates compared with HTK solution, without an addition. At 24 hours, we measured following values: 36 ± 4, 8 ± 3 and 6 ± 1 versus 48 hours, 34 ± 1, 2 ± 1, and 4 ± 1 in groups 2, 3, and 4. A similar pattern was observed with LDH (U/L) at 48 hours: 662 ± 89, 374 ± 151, and 386 ± 111, respectively. Lactate concentrations (mmol/L) were then significantly higher: 1.4 ± 0.3 in the TSH group and 1.2 ± 0.5 in the ACTH group as opposed to 0.2 ± 0.1 in unmodified HTK group. Conclusion: We observed the possibility of cytoprotective actions of TSH and ACTH addition to the perfusion fluid during cold ischemia, positive effects that were especially visible upon prolonged 48-hour storage.