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Biolasol: novel perfusion and preservation solution for kidneys.

INTRODUCTION:

Biolasol solution (Pharmaceutical Research and Production Plant “Biochefa,” Sosnowiec, Poland) is a novel extracellular perfusion and ex vivo hypothermic kidney preservation solution. It ensures maintenance of homeostasis, reduces tissue edema, has low viscosity, and allows the graft to preserve structural and functional integrity. It minimizes ischemia-reperfusion damage.

METHODS:

Perfundates from control and transplanted kidneys flushed with Biolasol or ViaSpan solutions (Arkas, Warszawa, Poland) were analyzed. Parameters of serum and urine collected from 12 pigs after auto-transplantation were also analyzed. Renal medulla was investigated for structural alterations by analyzing hematoxylin and eosin-stained slides. The mean survival time of pigs after the auto-transplantation procedure was the measure for the novel Biolasol solution effectiveness.

RESULTS:

We observed a statistically significant decrease in marker enzyme levels alanine transaminase, aspartate transaminase, lactic dehydrogenase, and ions (Na and K) in pigs with grafts flushed with Biolasol. Histopathologic examination revealed that the renal cortex structure was not damaged after the use of Biolasol solution.

CONCLUSION:

Biolasol solution protects kidneys against ischemia damage and does not differ significantly from the “golden standard” ViaSpan solution.

STERITALC®

Controlled particle size talc for use in the pleural cavity

STERITALC® consists of talcum which is mined in France and is specifically processed for medical use (talcum pleurodesis).

STERITALC® is suited for all indications of pleurodesis. It is non-soluble and induces permanent pleurodesis. Compared with tetracyclines, talcum is more effective and less painful.

As a rule, for malignant indications 3 to 5 g are used, for treatment of spontaneous pneumothorax 2 g are sufficient in most cases.

A critical side effect of talcum pleurodesis can be ARDS (Acute Respiratory Distress Syndrome). A possible cause of ARDS may be the systemic dissemination of talcum. In some cases, after application in the pleural cavity, talcum was found in other organs (kidneys, spleen, liver), too. The literature assumes that there is a relation between the talcum particle size and the systemic dissemination of talcum: smaller talcum particles appear to disseminate more than larger ones1). The clinical picture also shows the effect of different particle sizes: talcum with a mean particle size below 15 µm induced stronger systemic and pulmonary inflammation reactions than talcum with a mean particle size of 25 µm.

STERITALC®, produced by Novatech, is specifically calibrated to a mean particle size of 25 µm in order to avoid systemic dissemination. Animal3) and clinical studies2) show the lesser systemic dissemination.

A multi-center study showed that STERITALC® with its calibrated particle size can be safely used for pleurodesis of malignant pleural effusions. None of more than 550 patients developed ARDS4). The authors recommend to use no other talcum.

Another cause of ARDS may be a sepsis due to unsterile talcum, or talcum containing endotoxines5). This, too, can be excluded when STERITALC® is used, because STERITALC® is free of endotoxines and comes sterile.

1) Ferrer, CHEST 2002; 122: 1018-1027
2) Maskell, Am .J. Respir. Crit. Care Med. 2004; 170: 377-382
3) Fraticelli, CHEST 2002; 122:1737-1741
4) Janssen, Lancet 2007; 369: 1535-1539
5) Antony, Eur. Respir. J. 2001; 18: 402-419