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Assessment of Homograft Compatibility

which resembles intracellular fluid in ionic composition and strength. Twelve hours is usually quite sufficient time for transporting the kidney to the most suitable recipient and for making arrangements for the transplant operation. Occasionally longer periods of preservation are required and this can be achieved by perfusing the kidney on a special preservation machine. The machine perfuses the kidneys with a cold plasma-based fluid which is kept oxygenated and at the correct pH. During perfusion the viability of the kidney can be assessed in some measure, allowing severely damaged ones to be identified and discarded. Whether perfused kidneys function longer is a matter for debate. In an Australian series of cadaver transplants a greater percentage of perfused kidneys survived one year when compared with those that had merely been cooled (Sheil et al. 1975). However, in a large series of transplants carried out in California this was not confirmed; in fact, in this study the perfused kidneys functioned for a considerably shorter time (Fine et al. 1975).