Change in kidney morphology after ischemia/reperfusion in a sheep model of acute heart failure supported by pulsatile catheter pump / 中国组织工程研究

ABSTRACT

BACKGROUND: Acute renal failure following heart failure assisted circulation have been extensively reported. However, little data have been available concerning morphological analysis of kidney tissues under that condition.OBJECTIVE: To observe morphological change of ischemia/reperfusion kidney in a sheep pulsatile catheter (PUCA) pump short-term support for heart failure model and explore causes of acute renal failure in assisted circulation patients.DESIGN, TIME AND SETTING: Self-contrast animal experiment was performed at the laboratory of Department of Cardiothoracic Surgery, Renji Hospital of Shanghai Second Medical University between July 2003 and April 2004.MATERIALS: PUCA pump was provided by Gerhard Rakhorst, Professor of Biomedical Engineering, University of Groningen.METHODS: After ischemic heart failure in 10 sheep was induced successfully and subsequently ischemia/reperfusion kidney was developed, PUCA pump was activated to support the hemodynamics for 3 hours.MAIN OUTCOME MEASURES: Hemodynamic parameters were monitored and recorded before thoracotomy, heart failure, and every 45 minutes after the support. Kidney biopsy specimens for light and electron microscopy were obtained 3 hours after support.RESULTS: PUCA pump support was successful in 7 of 10 sheep for 3 hours. During support with the PUCA pump,Hemodynamic parameters gradually restored to normal and stable condition, and blood pressure was close to baseline at the end of experiment. On both light and electron microscopy examination, mild acute kidney change was observed after ischemia/reperfusion. Cytosis in renal glomerulus associated with vasodilatation hyperemia, endepidermis in renal tubules hydropic degeneration, vasodilatation hyperemia and Interstitial edema in renal medulla were the main findings.CONCLUSION: PUCA pump could successfully maintain the hemodynamics for 3 hours in a sheep acute heart failure model,but pathological change in ischemia/reperfusion kidney was remained. It is impossible to predict prognosis of renal function on hemodynamic data alone during support.