Mechanism of action of “intracellular” renal preservation solutions

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Abstract
Brief perfusion with Collins' C4 solution is commonly employed for hypothermic storage of kidneys for short periods, but the mechanism of action has never been satisfactorily explained. In the studies described in this report, an attempt was made to discover the essential ingredients so that a more reproducible solution could be formulated. Rabbit kidneys were excised, infused with a number of test solutions, stored at 4°C, and then autografted into recipients in which a contralateral nephrectomy had been performed. Starting with a buffered balanced salt solution, it was found that increasing the osmolality with glucose produced a dramatic improvement in function, while replacing half of the chloride by sulfate produced a further small improvement. The other changes were either deleterious (increasing potassium or magnesium concentration) or had no effect (reducing ionic strength). It is concluded that the benefit conferred by these solutions during storage is unrelated to intracellular ionic composition but is due to the inclusion of impermeant solutes to raise total osmolality.

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