Adenosine receptor antagonists, especially aminophyllline, are used to
treat or prevent acute renal failure. In the preferred embodiment, aminophylline
is administered by infusion so that it does not exceed a serum theophylline level
of 15-20 micrograms/ml, most preferably the aminophylline is administered to achieve
a serum theophylline concentration of 3-10 micrograms/ml, with an infusion rate
of 0.1-0.6 mg/kg IBW/hour (IBW=ideal body weight). The adenosine receptor antagonist
can also be used to help sustain a kidney for transplant purposes. Preferably,
aminophylline is loaded while the kidney is still part of the donor. A dose of
aminophylline of 5 mg/kg lean body weight is infused into the donor over a 30-60
min period, with cardiac monitoring. The infusion dose is decreased in the event
of supraventricular or ventricular tachycardias. The kidney is removed and placed
in the standard "cold" bath, but containing aminophylline at a dose of 5-10 micrograms/ml
(5-10 mg/l). The kidney is then transported to the recipient. The recipient is
similarly preloaded with 5 mg/kg lean body mass aminophylline intravenously over
30-60 min with cardiac monitoring, with a constant infusion of 0.1-0.3 mg/kg lean
body mass/hr continuing during the next 24 hours after the kidney is transplanted
into the recipient.