Protective Effects of Quercetin and Sucrose on Cold Preservation Injury in Porcine Kidneys Donated After Cardiac Death.

BACKGROUND The University of Wisconsin (UW) solution is the gold standard for kidney preservation. Quercetin (QE), a widely used flavonoid, possesses strong antioxidant, anti-inflammatory, and anti-apoptotic properties. Sucrose (Suc) has shown beneficial effects as a supplement. The aim of this study was to investigate the protective effects of QE and Suc against cold injury in porcine kidneys and to evaluate whether their use improves ischemia-reperfusion (I/R) injury after simple CS. MATERIAL AND METHODS Kidney grafts were procured after 30 min of warm ischemia, followed by preservation under 2 conditions for 22 h: Group 1, preserved with CS/UW solution (n=4), and Group 2, preserved with CS/UW solution containing QE 33.1 μM and Suc 0.1 M (n=6). All grafts were evaluated using an ex vivo isolated kidney reperfusion model with oxygenated, diluted autologous blood at room temperature. RESULTS At the end of reperfusion, creatinine phosphokinase and lactate dehydrogenase levels were significantly lower in Group 2 than in Group 1. We observed more vacuolation in the tubular epithelial cell in Group 1 than in Group 2, and the tubular epithelium showed more irregularity and exfoliation in Group 1 than in Group 2. Additionally, Group 2 had a significantly higher number of anti-ERG-positive endothelial cell nuclei than Group 1 at the end of reperfusion. CONCLUSIONS Our results suggest that the addition of QE and Suc to UW solutions can effectively prevent cold injury in DCD kidneys, with QE exerting this beneficial action, possibly by suppressing oxidative stress, and could potentially enhance kidney transplantation outcomes.