Background: As warm ischaemic damage is a major reason for the loss of donor organs, an experimental study was performed in order to evaluate retrograde oxygen persufflation (ROP) as a method to extend the warm ischaemic tolerance of kidneys.
Methods: Kidneys of 32 pigs were exposed to warm ischaemia for 60, 90 or 120 min. Then, 16 kidneys were subjected to ROP for 4 h at 4 degrees C and 16 controls were stored in cold UW-solution, followed by autotransplantation.
Results: Only in the group with 60 min warm ischaemic time and ROP did all animals survive the observation period of 7 days. In all other groups some animals died due to anuria. Short-term survivors in these groups had significantly higher creatinine levels.
Conclusions: In this setting, ROP was superior to cold storage when applied after 60 min of warm ischaemia. Clinical evaluation of ROP in the setting of marginal donors and non-heartbeating donation is recommended.