Optimization of the Kinetics of Cooling of Kidneys: A Pig Model

Savioz, D; A, Jeanjacquot; Savioz, Mélanie; Ludwig, Corinna; Chilcott, Michael; Bolle, J; Graf, Jean-Daniel; Nastasi, Antonio; Morel, Philippe

doi:10.1159/000008615

Cited by 8 publications

(6 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, reliable and objective data on the technical efficacy of cooling by this and all other methods is lacking. Very few groups have actually measured whether the desired temperature of 0–4 °C is ever reached in the time that elapses between the beginning of perfusion and actual organ retrieval [41]. In addition, the time span needed to reach adequate cooling via various techniques is largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Non-heart beating organ donation: overview and future perspectives

2007

View full text Add to dashboard Cite

Summary New indications for organ transplantation combined with a stagnating number of available donor grafts have severely lengthened the waiting list for almost all types of transplantations. This has led to a renewed interest in non‐heart beating (NHB) donation, as a possible solution to bridge the gap between supply and demand. In this review, we present an overview of current NHB donation practice, outcome, existing problems and future perspectives. We focus on possible improvements in donor management, recipient care and new methods of organ preservation that may be better suited for these marginal organs. Successful institution of NHB protocols depends on adapting current transplantation practice at all levels, which is one of the greatest challenges for researchers and professionals in this interesting re‐emerging field.

show abstract

Section: Introductionmentioning

confidence: 99%

Non-heart beating organ donation: overview and future perspectives

2007

View full text Add to dashboard Cite

show abstract

“…The establishment of kidney transplantations as routine terminal treatment of severe kidney failure [6, 7]lead to new aspects in basic renal research: As the donor kidneys are subject to warm and cold ischemia due to the surgical process of explantation, the investigation of the ischemia- and reperfusion-related injuries and consecutive development of reperfusion injury-minimizing techniques could improve graft survival [8, 9]. …”

Section: Introductionmentioning

confidence: 99%

A Model of Isolated Autologously Hemoperfused Porcine Slaughterhouse Kidneys

Große-Siestrup¹,

Unger²,

Fehrenberg³

et al. 2002

Nephron

View full text Add to dashboard Cite

Background: The rapidly evolving field of transplantation research with a focus on ischemic and reperfusion injuries has gained importance since the methodology of organ preservation significantly limits graft survival. Numerous models of isolated perfused kidneys have been established in the past years but limitations such as organ size, perfusate and ethical standards have restricted a widespread research in this area. Methods: A model of hemoperfused isolated porcine slaughterhouse kidneys was established which encompasses the advantages of autologous blood as optimal perfusate and a reduction of animal experiments. Results: The size and geometry of the porcine kidney is more comparable to human conditions and various renal functions, blood parameters and morphology can easily be accessed in the present model. Stable organ function can be maintained over 2 h with an amount of 500–1,000 ml of autologous blood which is metabolically controlled via a dialysis system. Conclusion: In summary, the present model describes a new and economic approach for targeting renal function in transplantation models by combining autologous blood as optimal perfusate with a well-defined organ geometry and function and slaughterhouse animals as a source.

show abstract

“…There is surprisingly little literature on kidney temperature during retrieval. In a pig model of multiple organ retrieval, the rate of temperature decrease of the right kidney varied between 0·6°C per min and 1·3°C per min during the procedure, although data from Mikhalski and colleagues suggested that there is some rebound of temperature after the initial cooling by cold flush. They measured kidney temperature during retrieval and observed an average mean(s.d.)…”

Section: Discussionmentioning

confidence: 99%

“…Topical cooling means that the organs are covered with ice slush. Despite these manoeuvres, the kidney cools slowly and its temperature might not reach 0–4°C inside the donor body. Until the kidney has cooled down, best achieved by storage on ice, it will continue to experience higher metabolic rates.…”

Section: Introductionmentioning

confidence: 99%

Effect of donor nephrectomy time during circulatory-dead donor kidney retrieval on transplant graft failure

Heylen

Pirenne

Samuel

et al. 2019

British Journal of Surgery

View full text Add to dashboard Cite

Background: When the blood supply ceases in a deceased organ donor, ischaemic injury starts. Kidneys are cooled to reduce cellular metabolism and minimize ischaemic injury. This cooling is slow and kidneys are lukewarm during nephrectomy. Smaller single-centre studies have shown that prolonged donor nephrectomy time decreases early kidney transplant function, but the effect on long-term outcome has never been investigated in large multicentre cohort studies. Methods: The relationship between donor nephrectomy time and death-censored graft survival was evaluated in recipients of single adult-to-adult, first-time deceased-donor kidneys transplanted in the Eurotransplant region between 2004 and 2013.Results: A total of 13 914 recipients were included. Median donor nephrectomy time was 51 (i.q.r. 39-65) min. Kidneys donated after circulatory death had longer nephrectomy times than those from brain-dead donors: median 57 (43-78) versus 50 (39-64) min respectively (P < 0⋅001). Donor nephrectomy time was independently associated with graft loss when kidneys were donated after circulatory death: adjusted hazard ratio (HR) 1⋅05 (95 per cent c.i. 1⋅01 to 1⋅09) per 10-min increase (P = 0⋅026). The magnitude of this effect was comparable to the effect of each hour of additional cold ischaemia: HR 1⋅04 (1⋅01 to 1⋅07) per h (P = 0⋅004). For kidneys donated after brain death, there was no effect of nephrectomy time on graft survival: adjusted HR 1⋅01 (0⋅98 to 1⋅04) per 10 min (P = 0⋅464). Conclusion: Prolonged donor nephrectomy time impairs graft outcome in kidneys donated after circulatory death. Keeping this short, together with efficient cooling during nephrectomy, might improve outcome.

show abstract

Optimization of the Kinetics of Cooling of Kidneys: A Pig Model

Cited by 8 publications

References 7 publications

Non-heart beating organ donation: overview and future perspectives

Non-heart beating organ donation: overview and future perspectives

A Model of Isolated Autologously Hemoperfused Porcine Slaughterhouse Kidneys

Effect of donor nephrectomy time during circulatory-dead donor kidney retrieval on transplant graft failure

Contact Info

Product

Resources

About