THEODORE I. MALININ 
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DISCUSSION 
Chairman Frank J. Veith : I want to thank 
Dr. Malinin for his very nice presentation. I 
have one question. What are your thoughts 
about Belzer's recent observation that the kid- 
ney is unique in that it can be preserved by 
perfusion at 10 °C because of its special enzyme 
system, and that the same sort of perfusion 
won't work for liver or other organs? 
Dr. Malinin: I think this is quite correct, 
and it seems to be a difference between the kid- 
ney and heart, too. We obtain best results with 
the kidney at about 10 °C, while the heart ap- 
pears to survive better between 15 and 18°C. 
Perhaps we have not been successful in pre- 
serving liver because we simply haven't found 
373 
the temperature at which this organ can be 
maintained in vitro. 
Chairman: Your point that the PAH and 
inulin clearance on the perfusion pump are a 
good in vitro test shouldn't be dismissed lightly. 
If this is indeed the case, it is a very valuable 
contribution, because all of us who are faced 
with the problems of perfusing organs are also 
faced with the problem of putting in organs 
that don't work. Can you tell us how accurate 
this test is? 
Dr. Malinin: Well, of course this work is 
preliminary. We have done it in rabbits only 
and have not extended it to people or larger 
animals. I would like to emphasize the differ- 
ence between the clearance and the extraction. 
The clearance, if properly done by standard 
methods, is an extremely long and cumbersome 
procedure, and we need a test which will give 
results in 10-15 minutes. With extraction, we 
only need one sample taken concommitantly 
from the artery and the vein so we can measure 
the difference between the two. So, the data 
from extraction plus the pH give the necessary 
information. We have not had failures in re- 
implanted organs where extraction has been 
demonstrated, while we have had numerous 
failures with urine production and with ade- 
quate flow (which of course could be erroneous 
because of the ruptured blood vessels) in the 
organs which have been reimplanted without 
such testing. 
Chairman : This is certainly a very exciting 
observation, and we will await your future 
comments on this particular test. 
