Histological evaluation of the effectiveness of intraoperative pharmacocold protection of kidneys in acute ischemia in the experiment

Acute ischemic kidney injury is a serious complication in aortic and renal artery surgery. The development of optimal methods of intraoperative protection, such as local pharmaco-cold perfusion, remains a pressing issue.

The aim of this study in rabbits was to comparatively evaluate the histological efficacy of two perfusion regimens (continuous drip and fractional) with cooled Ringer’s and Custodiol-based solutions during 60-minute ischemia.

Materials and Methods. The study was performed on 22 rabbits divided into 6 groups: intact control, an ischemia model without protection, and 4 groups with different perfusion methods (continuous/fractional, Ringer’s-FG/Custodiol solution). After 60 minutes of renal artery ischemia with parallel perfusion and 48 hours of reperfusion, histological and morphometric examination of the renal tissue was performed.

Results and discussion. Ischemia without protection caused significant damage: glomerular congestion, atrophy, and tubular degeneration and necrosis. All perfusion protocols significantly reduced the severity of damage. The key factor in efficacy was the administration mode: continuous drip perfusion was significantly more effective than fractional perfusion (p ≤ 0.05). Continuous drip perfusion with cooled Ringer’s solution at low pressure (35–45 mmHg) demonstrated the most balanced protective effect on both nephron compartments.

Conclusion. Continuous drip perfusion of solutions for pharmaco-cold perfusion is superior to fractional perfusion. The optimal method for experimental conditions is continuous drip perfusion with chilled Ringer’s-FG solution under low pressure, ensuring the best preservation of both the glomerular and tubular apparatus of the kidney.

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