The Elimination of Warm Ischemic Time in Kidney Transplantation Using the Ice Bag Technique: A Feasibility Study

Ortíz, Jorge; Siddeswarappa, Madhu; Sea, Stephanie; Parsikia, Afshin; Campos, Stalin; Khanmoradi, Kamran; Zaki, Radi

doi:10.1016/j.jecm.2011.06.004

Cited by 11 publications

(13 citation statements)

References 2 publications

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“…The IBT was feasible, and we did not observe any technique-related complications. The previous studies, while informative, failed to demonstrate the influence of IBT on subsequent graft function and transplant outcome2426. Thanks to the paired-kidney randomized analysis concerning grafts from the same donor, we were the first to show the correlation between effective cooling and not only short-term allograft function but also reduced number of posttransplant detrimental events like acute rejection and delayed graft function29.…”

Section: Discussionmentioning

confidence: 82%

“…Several attempts have been made to achieve kidney cooling during anastomosis, from the ice-filled jacket22, stockinette23 and holding net with attached cold drip infusion set15 in the past, to the polyethylene bags filled with ice (IBT)2124252627 or retroperitoneal cooling during robotic procedures28 at present time. In our study, cooling was achieved using a specially designed polyethylene bag filled with slushed sterile ice in which the kidney was placed until reperfusion.…”

Section: Discussionmentioning

confidence: 99%

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The influence of warm ischemia elimination on kidney injury during transplantation – clinical and molecular study

Kamińska

Kościelska‐Kasprzak

Chudoba

et al. 2016

Sci Rep

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Kidney surface cooling was used during implantation to assess the effect of warm ischemia elimination on allograft function, histological changes and immune-related gene expression. 23 recipients were randomly assigned to a group operated on with kidney surface cooling during implantation (ice bag technique, IBT group), and the other 23 recipients receiving the contralateral kidney from the same donor were operated on with a standard technique. Three consecutive kidney core biopsies were obtained during the transplantation procedure: after organ recovery, after cold ischemia and after reperfusion. Gene expression levels were determined using low-density arrays (Format 32, TaqMan). The IBT group showed a significantly lower rate of detrimental events (delayed graft function and/or acute rejection, p = 0.015) as well as higher glomerular filtration rate on day 14 (p = 0.026). A greater decrease of MMP9 and LCN2 gene expression was seen in the IBT group during total ischemia (p = 0.003 and p = 0.018). Elimination of second warm ischemia reduced the number of detrimental events after kidney transplantation, and thus had influence on the short-term but not long-term allograft function. Surface cooling of the kidney during vascular anastomosis may reduce some detrimental effects of immune activation resulting from both brain death and ischemia-reperfusion injury.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

The influence of warm ischemia elimination on kidney injury during transplantation – clinical and molecular study

Kamińska

Kościelska‐Kasprzak

Chudoba

et al. 2016

Sci Rep

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“…1 Ortiz et al reported 7 cases of RACS out of 502 renal transplants with overall incidence of 1%. 4 Studies looking at methods of fascial closure posttransplantation document suspected and confirmed cases of RACS; Wood et al reports 95 suspected cases and 11 confirmed and Beasley et al reports 13 suspected cases and 4 confirmed cases (cases were confirmed upon exploration). 1 In total, inclusive of studies and isolated case reports, there are 38 confirmed cases reported and 110 suspected cases (Table 1).…”

Section: Incidencementioning

confidence: 99%

“…Though there are multiple factors that contribute to graft dysfunction in the post-operative period, RACS should always be a consideration. 4,5 Diagnosis Several risk factors have been attributed to RACS. The authors speculate that vascular compression in recipients with a BMI of under 18, leads to technical graft loss and hence poorer graft survival.…”

Section: Incidencementioning

confidence: 99%

Renal allograft compartment syndrome: a review

Tang

Lee

Yuen

et al. 2021

ANZ Journal of Surgery

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Renal allograft compartment syndrome (RACS) is the result of extrinsic compression resulting in graft dysfunction and loss due to ischaemia. A literature review was performed by computerized searches from the following data sources Medline, EMBASE, PubMed and Cochrane Library databases. Risk factors include size mismatch between graft and recipient. Intraoperative suspicion should be exercised if there is poor tissue turgor, cyanosis and loss of urine output upon fascial closure. Doppler ultrasound is the modality of choice amongst the literature to aid in diagnosis of RACS. From our study, the accepted form of treatment is early detection and appropriate surgical intervention. Nevertheless, it is clear from the paucity of literature that further investigation into this area of transplantation is necessary.

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“…Jedną z pierwszych była technika polegająca na wykorzystaniu gąbki nasączonej płynem prezerwującym o temperaturze lodu i umieszczeniu w tym przeszczepianej nerki [20]. Kolejne rozwiązanie opisali w 1994 r. Gill et al [6,21], którzy w grupie ok. 1000 biorców uzyskali redukcję WIT II poprzez użycie bawełnianej "pończochy" (cotton stockinette), w której na czas zespoleń naczyniowych umieszczano nerkę wraz z topniejącym lodem.…”

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Methods of Reduction of Warm Ischemic Time in Kidney Transplantation and Their Role of Early and Late Outcomes

et al. 2016

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Kidney is the organ transplanted most often. An increase in the number of expanded criteria donors (ECD) has been observed for years, and consequently the condition of transplanted organs worsened. In recent years, the possibility to recover organs from donors after cardiac death (DCD) became legally available in Poland, which will result in the increase of donors. Every DCD donor is at the same time ECD donor. One of the most important challenges the transplantology has to face is the improvement of the quality of transplanted organs. In this study the available data on the reduction of warm ischemic time (WIT) on transplanted kidney has been presented. WIT may influence early and late outcome of kidney allograft. Long WIT increases the risk of delayed graft function (DGF). DGF occurs more often in transplanted kidneys from DCD. One of the main reasons for that is the fact that DCD have longer WIT compared to donors after brain death (DBD). So-called WIT II appearing during vascular anastomosis in kidney transplantation may be reduced by various techniques. The model of clear sterilized polyethylene bag developed by the authors has been presented. The construction of the bag, consisting of three compartments, allow to safely perform vascular anastomosis while keeping the temperature of the transplanted kidney low. The article describes as well other techniques used to decrease WIT II. The effect of anastomosis time on allograft outcome is still not well researched. The article presents the newest information regarding the influence of WIT on graft and patient survival.

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The Elimination of Warm Ischemic Time in Kidney Transplantation Using the Ice Bag Technique: A Feasibility Study

Cited by 11 publications

References 2 publications

The influence of warm ischemia elimination on kidney injury during transplantation – clinical and molecular study

The influence of warm ischemia elimination on kidney injury during transplantation – clinical and molecular study

Renal allograft compartment syndrome: a review

Methods of Reduction of Warm Ischemic Time in Kidney Transplantation and Their Role of Early and Late Outcomes

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