Is it possible to prevent reperfusion ischemic injury and DGF (delayed graft function) in kidney allograft? How?
1Organ Transplantation Department, Tabriz Medical Science University, Tabriz, Iran (Islamic Republic of)
Introduction: Still, the kidney transplantation is the best choice for treatment of chronic renal failure, and if unrelated donor is option for transplantation deceased donor is the best modality for doing it, but there are many problems with deceased donor in which DGF is the most important one which sometimes may be result in graft lost or patient loss .so in our transplant department was decided to stopping or deferring DGF.
Materials and Methods: In 20 Chronic renal failure patients age (between 25 and 55 years, 14 males, 6 females) 6 males and 4 females as donors were selected for kidney transplantation. In ten cadavers which in all of them the creatinine was high because of pre renal hyper azotemia. The minimum creatinine after improving the pre renal condition with fluid and rising blood pressure was 1.6mg/dl. In back table in every kidney through renal artery 80 mg papaverin injected and immediately after injection small bull dog applied. In all of them induction were with thymo and three medicines: prograft, prednisolone, celcept.
Result: In all kidney after declamping immediately diuresis was started and at least in first 24 hours of transplantation the volume of urine was about 65 00cc there was not any DGF case and at third day of surgery creatinine of serum was in normal range.
Conclusion: Relaxing smoot muscle of artery by papaverine is the strongest prevention of DGF in which slowing blood flow and constriction in parenchyma of kidney is the first step for initiation DGF and up-regulated Toll like receptor in endothelial of artery it may change the fate of cadaveric kidney transplantation.
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