Prevention of oliguric ATN following living renal transplantation by PRE-operative allopurinol

ABSTRACT

The incidence of pathologically documented oliguric A.T.N. following living renal transplantation was studied in 481 cases using different perfusion protocols with comprised together with surface cooling perfusion with 500 ml lactated Ringer's solution at room temperature to which 5000 units heparin were added together with 5 mg verapamil and 2 ml 2% procaine HC1 in the firs group, or 6 ml 2% procaine HC1 in the second and third groups. This was followed in the 3 groups by cold [0C] perfusion of 500 ml lactated Ringer's solution to which 500 units heparin were added. Perfusion time ranged form 3-5 minutes. Oliguric A.T.N. occurred in 6/159 cases [3.8%] of the first group and in 13/227 cases [5.7%] of the second group. Oliguric A.T.N. was not encountered in any of the 95 cases in whom allopurinol was given to both donor and recipient as 300 mg orally 48 and 24 hours preoperatively and using procaine HCL for perfusion. A.T.N. Was not related to the duration of the ischemia time [35-65 minutes], number of arteries or tissue matching which were comparable among the studied groups. Allopurinol is believed to protect against reperfusion injury mediated by free oxygen radicals