Selective Hypothermic Perfusion of the Kidney for Intrarenal Surgery

Lv, Wagenknecht; Hupe, W; Bücheler, E; Klosterhalfen, H

doi:10.1159/000472060

Cited by 14 publications

(3 citation statements)

References 8 publications

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“…the preceding renal function is not known and some kid-neys have been subjected to warm ischaemia. In humans the efficacy of different kidney preservation methods must be studied in connection with bloodless renal surgery in situ (Wagenknecht et al, 1977;Wickham et al, 1979) or extracorporeally. In situ, however, the choice of the perfusate is limited as solutions with a high potassium content cannot be used.…”

Section: Discussionmentioning

confidence: 99%

Function of Human Autologous Kidney Grafts after Extracorporeal Preservation with Sacks' II Solution

Ranch

Brynger

Granérus

et al. 1985

British Journal of Urology

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The function of 18 human kidney grafts was studied before and 3 months after autotransplantation without prior bench surgery on the parenchyma or the vessels. Kidney protection was accomplished by pre-treating the patient with mannitol and low molecular weight dextran solution and flushing the kidney with a Xylocaine-heparin mixture and cold Sacks' II solution. The mean cold ischaemia time was 239 min (range 140-345 min). The glomerular filtration rate (GFR) remained unchanged post-operatively in terms of both total and split kidney GFR. Proximal and distal tubular integrity, as studied by determination of beta2-microglobulin excretion and concentration ability respectively, was also preserved.

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Section: Discussionmentioning

confidence: 99%

Function of Human Autologous Kidney Grafts after Extracorporeal Preservation with Sacks' II Solution

Ranch

Brynger

Granérus

et al. 1985

British Journal of Urology

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“…Perfusion of the kidney with a cold solution instilled via the renal artery not only may have a theoretic risk of tumor dissemination, but also requires participation of an intervention radiology team to perform preoperative renal artery catheterization, adding complexity and risks of potential complications to the procedure [3]. On the contrary, continuous renal perfusion might have the advantage of providing a more homogeneous and effective hypothermia for a more extended period of time [99, 100]. It is generally accepted, founded on data extrapolated from the kidney stone literature, that adequate hypothermia provides up to 2 to 3 hours of renal protection from circulatory arrest [99, 101–104].…”

Section: What Are the Factors Affecting Tolerance Towarm Ischemia?mentioning

confidence: 99%

“…On the contrary, continuous renal perfusion might have the advantage of providing a more homogeneous and effective hypothermia for a more extended period of time [99, 100]. It is generally accepted, founded on data extrapolated from the kidney stone literature, that adequate hypothermia provides up to 2 to 3 hours of renal protection from circulatory arrest [99, 101–104]. …”

Section: What Are the Factors Affecting Tolerance Towarm Ischemia?mentioning

confidence: 99%

Importance and Limits of Ischemia in Renal Partial Surgery: Experimental and Clinical Research

Secín

2008

Advances in Urology

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Introduction. The objective is to determine the clinical and experimental evidences of the renal responses to warm and cold ischemia, kidney tolerability, and available practical techniques of protecting the kidney during nephron-sparing surgery. Materials and methods. Review of the English and non-English literature using MEDLINE, MD Consult, and urology textbooks. Results and discussion. There are three main mechanisms of ischemic renal injury, including persistent vasoconstriction with an abnormal endothelial cell compensatory response, tubular obstruction with backflow of urine, and reperfusion injury. Controversy persists on the maximal kidney tolerability to warm ischemia (WI), which can be influenced by surgical technique, patient age, presence of collateral vascularization, indemnity of the arterial bed, and so forth. Conclusions. When WI time is expected to exceed from 20 to 30 minutes, especially in patients whose baseline medical characteristics put them at potentially higher, though unproven, risks of ischemic damage, local renal hypothermia should be used.

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The impact of in-situ balloon occlusion of the renal artery and hypothermic perfusion on renal blood flow

et al. 1978

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Unilateral renal blood flow was evaluated in-situ in 13 dogs by cineangiodensitometry and microsphere distribution studies before and after intermittent balloon occlusion with and without hypothermic perfusion of one kidney. The contralateral kidney served as control. No significant difference in renal blood flow and vascular resistance was noted before, and 5, 30 and 60 minutes after unilateral intra-arterial manipulation. Compartmental flow distribution studies in 5 dogs revealed no evidence of alteration of intra-renal haemodynamics. In a clinical pilot study, unilateral renal blood flow measured by cineangiodensitometry showed no change of clinical significance 5 and 60 minutes after intraluminal balloon occlusion of the renal artery for 60 seconds.

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Selective Hypothermic Perfusion of the Kidney for Intrarenal Surgery

Cited by 14 publications

References 8 publications

Function of Human Autologous Kidney Grafts after Extracorporeal Preservation with Sacks' II Solution

Function of Human Autologous Kidney Grafts after Extracorporeal Preservation with Sacks' II Solution

Importance and Limits of Ischemia in Renal Partial Surgery: Experimental and Clinical Research

The impact of in-situ balloon occlusion of the renal artery and hypothermic perfusion on renal blood flow

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