Impact of an intra-abdominal cooling device during open kidney transplantation in pigs.

Details

Serval ID
serval:BIB_CDAD0E3A442A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of an intra-abdominal cooling device during open kidney transplantation in pigs.
Journal
Swiss medical weekly
Author(s)
Longchamp A., Meier RPH, Colucci N., Balaphas A., Orci L.A., Nastasi A., Longchamp G., Moll S., Klauser A., Pascual M., Lazeyras F., Corpataux J.M., Bühler L.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Publication state
Published
Issued date
16/12/2019
Peer-reviewed
Oui
Volume
149
Pages
w20143
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Transplantation of kidneys from deceased donors is still associated with a high rate of postoperative renal dysfunction. During implantation into the recipient, the kidney rewarms. This second warm ischaemia time, which is not monitored, is harmful especially if prolonged. We recently developed an intra-abdominal cooling device that efficiently prevents kidney rewarming during robotic transplantation, and prevents ischaemia-reperfusion injuries. We tested the benefits of this cooling device during open kidney transplantation in pigs.
Kidneys were procured from large pigs by open bilateral nephrectomy. Following procurement, kidneys were flushed with 4°C Institut Georges Lopez-1 preservation solution, and placed on ice. Animals then underwent double sequential autologous open renal transplantation with (n = 7) and without (n = 6) intra-abdominal cooling.
Mean anastomosis time was similar between groups (43.9 ± 13 minutes). At reperfusion, the renal cortex temperature was lower in the group with cooling (4.3 ± 1.1°C vs 26.5 ± 5.5°C, p <0.001). The cooled kidneys tended to be protected from injury, including some histopathological ischaemia-reperfusion lesions. With the device, kidneys had a better immediate postoperative urine output (p = 0.05).
Our results indicate that the intra-abdominal cooling device significantly reduced second warm ischaemic time during transplantation, is technically safe and does not prolong anastomotic time.
Keywords
Abdominal Cavity, Animals, Body Temperature, Hypothermia, Induced/instrumentation, Kidney/pathology, Kidney Transplantation/methods, Models, Animal, Postoperative Period, Reperfusion Injury/prevention & control, Robotic Surgical Procedures, Swine, Urine, Warm Ischemia
Pubmed
Web of science
Open Access
Yes
Create date
03/01/2020 14:14
Last modification date
14/08/2020 6:21
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