Effect of different preservation solutions on adenine nucleotide content and metabolism in human kidney transplantation

Differences in purine metabolism produced by three preservation solutions were studied by determining the adenine nucleotide (ATP, ADP, AMP, and IMP) and nucleoside (adenosine, inosine, and hypoxanthine) levels in human kidney cortical biopsies. Forty kidney allografts were studied using University of Wisconsin (UW) solution (n=20), Euro-Collins (EC) solution (n=12), and modified EC solution with mannitol (M;n=8). No significant differences were found between the three solutions studied with regard to ATP, ADP, or AMP changes. The mean ATP level (nmol/mg prot±SEM) at the end of preservation in the UW group was 2.7±0.3 nmol/mg, in the EC group 3.8±0.7 nmol/mg, and in the M group 2.3±0.4 nmol/mg. ATP 30 min after reperfusion in the UW, EC, and M groups was 5.7±0.8 nmol/mg, 6.4±1.0 nmol/mg, and 4.6±0.5 nmol/mg, respectively. However, an important difference appeared in the catabolic products determined. Kidneys perfused with UW solution had a significantly higher level of adenosine (2.6±0.6 nmol/mg), inosine (11.8±2.2 nmol/mg), and hypoxanthine (18.1±2.1 nmol/mg) at hypoxanthine of cold storage than those perfused with EC (0.4±0.1 nmol/mg, 2.0±0.8 nmol/mg, and 7.1±1.4 nmol/mg) and M solutions (0.2±0.05 nmol/mg, 0.5±0.1 nmol/mg, and 5.2±0.6 nmol/mg; P<0.05). These levels returned to initial values 30 min postreperfusion and there were no differences with the EC or M solution groups at that time. Thus, the adenosine present in UW solution does not appear to be useful in recovering the adenine nucleotide pool at reperfusion. Moreover, it produces a marked increase in degradation products. Our findings do not support the beneficial metabolic effect of UW solution in terms of adenine nucleotide metabolism in comparison with simpler and less expensive preservation solutions like EC. © 1994 Springer-Verlag.