Evaluation de IGL-1, une nouvelle solution de conservation d'organes: Résultats pré-cliniques en transplantation rénale

Introduction: Renal ischaemia and reperfusion lesions partly determine short-term and long-term graft survival. Organ preservation conditions appear to play a decisive role. This article presents the preclinical experimental results obtained in renal transplantation with an extracellular organ preservation solution, in which polyethylene glycol (PEG) is used as colloid. Methods and Results: The effects of inversion of Na+ and K+ gradients in the IGL-1 preservation solution compared to UW and replacement of hydroxylethyl starch (HES) by PEG were evaluated in an ex vivo isolated, perfused rat kidney model and then in a pig renal autotransplantation model. In these experimental models, after 24 hours of static storage, the sodium reabsorption fraction correlated with the quality of tubular function of the kidney and the glomerular filtration rate were constantly better in the IGL-1 group than in the UW group. In vivo, in the pig, resumption of renal function was significantly better in the IGL-1 group and histological examination demonstrated a significant reduction of expression of Major Histocompatibility Complex (MHC) type II, an indirect marker of inflammation, but also a reduction of markers of apoptosis and fibrosis for kidneys preserved in IGL-1. Conclusion: In animal renal transplantation, IGL-1 ensures better resumption of renal function than UW, which currently remains the "gold standard" preservation solution. Further studies must be conducted to determine whether this new generation solution can replace UW as the reference solution.