New Developments in Kidney Preservation
When one overlooks the history of kidney preservation, it is impressive what has been reached in a period of just thirty years, assuming that the real kidney preservation started with the introduction of hypothermia. In 1952 Lefebre and Nizet (1) introduced cold storage aiming at a reduction of cellular metabolism. They cooled the kidney by immersing it in a cold solution (surface cooling). Flushing of the vascular tree of the kidney with a cold solution was introduced by Pegg and Calne (2) in 1963 and a preservation period of 24 hours in the dog model was reached. In the USA Humphries (3) worked on machine preservation and reached 48 hours in 1964. In 1967 Belzer (4) introduced cryoprecipitated plasma as perfusate in a modified machine constructed by him and his co-workers. Since their work cadaveric kidney transplantation is performed on an elective basis. Two years later, Collins (5) introduced the hyperosmolar solution for simple cold storage and it is this method, slightly modified as Eurocollins, that has reached overwhelming popularity in Europe. In the USA machine preservation has been the method of choice since Belzer’s publication, though since the retrospective study of Opelz and Terasaki (6), published in 1978, stating that no advantage of machine preservation over cold storage could be established, the scene in the USA is changing towards cold storage. At the end of this bird’s-eye survey of the development of preservation — far too short and not given credit to all the work performed — the question can be posed: How good then is this cold storage?
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