1991
DOI: 10.1055/s-2007-1020006 View full text |Buy / Rent full text
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Abstract: The successful resection of an abdominal aortic aneurysm is presented in a patient who had undergone kidney transplantation 4 years previously. Because the transplanted kidney is more sensitive to ischemia than a normal one, a femoro-femoral bypass with a pump oxygenator was used for perfusion of the transplanted kidney during crossclamping. During the clamping time of 40 minutes kidney perfusion was maintained with a perfusion pressure of 60 to 80 mmHg and the flow was 600 to 1000 ml/min. A collagen-seeded Da… Show more

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“…Methods have been proposed with the unifying purpose of allowing effective aortic replacement while minimizing the risk of allograft loss. These include the use of temporary shunts (1, 2), extracorporeal bypass (3), cold renal perfusion (4, 5), and general hypothermia (6). However, there are also some reports of successful aneurysm repair without any adjunctive renal protective measures (16, 17).…”
Section: Discussionmentioning
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rupbmjkragerfmgwileyiopcupepmcmbcthiemesagefrontiersapsiucrarxivemeralduhksmucshluniversity-of-gavle
“…Methods have been proposed with the unifying purpose of allowing effective aortic replacement while minimizing the risk of allograft loss. These include the use of temporary shunts (1, 2), extracorporeal bypass (3), cold renal perfusion (4, 5), and general hypothermia (6). However, there are also some reports of successful aneurysm repair without any adjunctive renal protective measures (16, 17).…”
Section: Discussionmentioning
“…[7][8][9][10] Most of the techniques described, however, require an additional procedure and prolong operative times. As such, several authors have argued that renal protection is not required during aneurysm repair and that expeditious surgery and retrograde perfusion alone are sufficient to prevent ischemic injury.…”
Section: Discussionmentioning
“…iliaca berichteten erstmals Campbell et al 1981. Sie verwendeten bei einem Patienten mit BAA nach NTX einen femoral arteriovenös angeschlossenen Pumpenoxygenator zur retrograden Transplantatnierenperfusion.Weitere Autoren griffen die Methode auf, in der Literatur finden sich hierzu weitere Fallberichte [3,37], wobei in einem Fall eine Biomedicuspumpe zur Perfusion einer Einzelniere nach iliakorenalem Bypass eingesetzt wurde [32]. In allen Mitteilungen konnte auch durch die Verwendung einer extrakorporalen Zirkulation die Nierentransplantatfunktion uneingeschränkt erhalten werden.…”
Section: Verschiedene Protektionsverfahrenunclassified
“…So werden in der Literatur zwar zahlreiche Methoden der Ischämieprotektion angegeben, die berichteten Fallzahlen einer Klinik sind aber stets sehr gering, meist handelt es sich um Fallberichte [1,3,4,7,8,9,12,14,15,16,23,25,28,29,30,31,32,37]. Art und Notwendigkeit einer Ischämieprotektion bei aortoiliakalen Eingriffen nach NTX werden daher kontrovers diskutiert.Wir nahmen diese Situation zum Anlass, unser eigenes Krankengut vorzustellen, bei dem in Abhängigkeit von Art und Lokalisation des aortoiliakalen Gefäßprozesses verschiedene ischämieprotektive Verfahren angewendet wurden.…”
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