Study on Preservation and Survival of Cadaveric Renal Graft with Warm Ischemia

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The objects of this study are as follows. 1) To find and establish a simple and easy method by which common physicians are able to preserve the cadaveric renal graft in cardiac arrest donors until a donation team arrives at a donor hospital. 2) To find markers that predict viability of the renal graft damaged by warm ischemia. 3) To decide an appropriate dosage of nephrotoxic immunosuppressant, cyclosporine or FK-506, in a recipient with a warm ischemia-damaged renal graft.From animal experiments and clinical observations, the following was induced. 1) Abdominal cooling of the cardiac arrest donor by ices and cold water is effective for renal preservation. 2) Bolus administration of heparin and steroid to the donor just after the cardiac arrest is also effective. 3) Aggressive and continuous heart manual massage of the cardiac arrest donor brings about good preservation. 4) Cold donor's abdominal cavity at laparotomy and smooth irrigation of the removed graft is good indicators of viability. 5) Combination immunosuppression of a half dosage of nephrotoxic cyclosporine or FK-506, azathioprine or mizoribine and antilymphocyte globulin is recommended in the severely damaged ATN graft.