Flush pressure requirements for optimal cadaveric donor kidney preservation

Studies in the canine model indicate that effective in situ flush cooling (ISFC) depends on the maintenance of flush pressures (FP) of at least 70 mm Hg. Low FP of 30 mm Hg (currently used during ISFC) produces reactive vasospasm leading to poor core cooling and inadequate expulsion of blood from the renal microvasculature. In an attempt to deliver the necessary flush pressure and flow rate to cadaver donor kidneys, a new ISFC tube - Anaise Organ Procurement Tube (AOPT) (Sheridan Corporation, Argyle, New York) - was developed. A prospective study was designed to compare the effectiveness of ISFC at high FP of 70 mm Hg with the results of low FP of 30 mm Hg. This preliminary report suggests that ISFC at an adequate FP produces improved graft function after transplantation, and highlights the need to deliver and monitor adequate levels (70 mm Hg) of FP during ISFC.