{'fraction_non_alphanumeric': 0.05279126213592233, 'fraction_numerical': 0.04550970873786408, 'mean_word_length': 3.834310850439883, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
[A new method to evaluate the viability of preserved kidney by myo-inositol levels in the early effluent perfusate ].

The correct prediction of the viability of the isolated or preserved kidney is very important in cadaver transplantation. At present, while there are various methods for evaluating the viability of renal graft, none is complete. Furthermore, the assessment of its viability is frequently based on the duration of warm or cold ischemia in simple cold storage. Therefore, an accurate, rapid and complete method for the prediction of renal viability is desirable. The author recently found that myo-inositol, a kind of cyclic polyol contained abundantly in the organ, is plentiful in the early effluent perfusate washed out from the preserved kidney. Based on these findings, attempts were made to develop for evaluating the viability of the preserved kidney by measuring the free myo-inositol (F. m I) levels in the early effluent perfusate (EEP). Herewith the satisfactory results of my experiments, in vitro and in auto-transplantation of the canine kidney, and clinical renal transplantation by the method are reported. The canine kidney was kept in ischemic condition for various periods at 4C or 37C and it was washed out with 4C lactated Ringer's solution (200 ml). The first effluent perfusate of 25 ml (EEP) was collected. As for the perfusate, F. m I was trimethylsililated and measured by gas-chromatography using a 2 m column of 5 % ucon coated. In vitro, the relationship between F. m I levels (Y) and cold ischemic time (X, hrs) for kidney was Y=0. 03X2-0. 04X+17. 72 (pg/ml), the coefficient of correlation (r) being 0. 858. The relationship between F. m I levels (Y) and warm ischemic time (X, hrs) came to Y=17. 9X2-16. 5X+15. 6 (pg/ml), r=0. 808, showing that F. m I levels were correlated markedly with the ischemic time of the preserved kidney. In auto-transplantation, the animals were classificated into the following three groups according to the graft function. I, the S Cr is less than 5 mg/dl. II, the S Cr rises up to ca 10 ml/dl but thereafter falls off gradually. III, the S Cr rises transiently and animals die within a week. The mean F. m I levels in EEP of those groups were I; 15. 62. 2 II; 32. 23. 5 and III; 67. 114. 5 pg/ml (meanS. E), respectively. And the relationship between F. m I in EEP and max. S-Cr levels of animals was Y=0. 168X+1. 70, r=0. 815. In control kidneys, the mean F. m I level in supernate of whole, cortex and medulla were 9. 541. 28, 2. 850. 38 and 21. 202. 32 pug/mg (meanS. D). On the other hand, in a 3 hr warm ischemic kidney, the mean F. m I level in supernate of those were 5. 901. 07, 2. 630. 36 and 16. 002. 17 pg/mg, respectively. F. m I in renal tissue is contained mainly in its medulla. And F. m I in renal medulla declines with long ischemia, although that of renal cortex dose not change. In clinical renal transplantation, the mean F. m I levels in total effluent perfusate of living and cadaver donor graft were 509. 1245. 7 and 1138130 pg (meanS. D). The mean F. m I levels in total effluent perfusate per 1 g of graft kidney were 3. 081. 35 and 7. 571. 40 pg/g (meanS. D). The mean F. m I levels in total effluent perfusate of early postoperative good and bad function grafts were 483231 and 1079153 pg.