Pretransplantation assessment of renal viability with NADH fluorimetry Joanna M. C.C. Coremans, Matthijs Van Aken, Daniëlle C.W.H. Naus, Marie-Louise F. Van Velthuysen, Hajo A. Bruining, Gerwin J. Puppels  Kidney International  Volume 57, Issue 2, Pages 671-683 (October 2000) DOI: 10.1046/j.1523-1755.2000.00889.x Copyright © 2000 International Society of Nephrology Terms and Conditions

Figure 1 (A) Schematic view of the nicotinamide adenine dinucleotide (NADH) videofluorimeter. (B) NADH fluorescence image of a perfused normoxic kidney showing five surface areas selected for fluorescence intensity analysis. The gray circle near the hilus of the kidney is a piece of fluorescence calibration glass. Kidney International 2000 57, 671-683DOI: (10.1046/j.1523-1755.2000.00889.x) Copyright © 2000 International Society of Nephrology Terms and Conditions

Figure 2 NADH oxidation kinetics in perfused rat kidney indicating (A) δFNADH/NAD+, the relative difference in NADH fluorescence intensity levels of the reduced and oxidized steady states, and (B) aNADH/NAD+, the slope of the tangent to the initial rapid NADH fluorescence intensity decrease. Kidney International 2000 57, 671-683DOI: (10.1046/j.1523-1755.2000.00889.x) Copyright © 2000 International Society of Nephrology Terms and Conditions

Figure 3 NADH oxidation kinetics in perfused rat kidneys with progressive ischemic injury. (A) Minimally damaged, P, kidney (group 1). (B) Compromised, 37°C P, kidney (group 2). The different symbols correspond to the average NADH fluorescence intensities of five surface areas of a single kidney. Kidney International 2000 57, 671-683DOI: (10.1046/j.1523-1755.2000.00889.x) Copyright © 2000 International Society of Nephrology Terms and Conditions

Figure 4 Development of renal function in the sham operated group (group 7) and in surviving unilaterally nephrectomized rats with transplanted minimally damaged kidneys ± perfusion (PTx, group 3; Tx, group 5), and with transplanted kidneys that had been stored for one hour at 37°C ± perfusion (37°C PTx, group 4; 37°C Tx, group 6). (A) Serum creatinine and (B) serum urea concentrations were determined at nephrectomy (□) and 3 () and 6 (▪) weeks later. Data given are means ± SD. *P < 0.05; Mann-Whitney U–Wilcoxon rank sum test relative to the sham operated control group. Kidney International 2000 57, 671-683DOI: (10.1046/j.1523-1755.2000.00889.x) Copyright © 2000 International Society of Nephrology Terms and Conditions

Figure 5 Light microscopic changes nine weeks after transplantation. (A) Minimally damaged PTx kidney (group 3) displaying normal renal architecture with tubules dos-à-dos. (B and C) 37°C PTx kidney (group 4) showing an important increase of interstitial tissue with leukocytic infiltrate and irregular tubuli (atrophic and cystic) with thickened tubular basement membrane (severe residual change). (A and B) PAS ×250. (C) PAS ×500. Kidney International 2000 57, 671-683DOI: (10.1046/j.1523-1755.2000.00889.x) Copyright © 2000 International Society of Nephrology Terms and Conditions

Figure 6 Initial NADH oxidation rate (aNADH/NAD+) of isolated perfused kidneys as a function of their post-transplantation (A) serum creatinine and (B) serum urea concentrations. Data points labeled 1 through 6 are from minimally damaged kidneys (PTx, group 3). Labels 7 through 12 correspond to kidneys that have been stored for one hour at 37°C before perfusion (37°C PTx, group 4). Data points present mean aNADH/NAD+ ± SD of individual kidneys. The horizontal bars indicate the group average (drawn line) ± SD (shaded area) of minimally damaged, PTx, kidneys (-473 ± 71% · min-1) and of compromised, 37°C PTx, kidneys (-217 ± 52% · min-1). Vertical bars indicate the normal ranges of serum creatinine and urea concentrations obtained from the Sham group. Kidney International 2000 57, 671-683DOI: (10.1046/j.1523-1755.2000.00889.x) Copyright © 2000 International Society of Nephrology Terms and Conditions