Transoperative renal intraarterial verapamil in kidney transplantation decreases acute tubular necrosis

López-Neblina, Fernando; Jimenez, Hernan; London, I Finkelstein; Valdez, B Gonzalo; Barcaz, A Luis Mauro Arteaga

doi:10.1016/s0041-1345(99)00656-9

Cited by 5 publications

(6 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This report includes the largest DCD cohort to examine intraoperative verapamil administration. Furthermore, unlike the prior studies of intraoperative verapamil that had short mean CIT <10 h, 16,18,21 our study population had a mean CIT >24 h, which is more reflective of the current practice in the United States, with wider geographic allocation of organs leading to longer CIT. The major limitation to this study is the nonrandomization of verapamil utilization.…”

Section: Discussionmentioning

confidence: 85%

“… 4 , 5 Prior studies found a reduced incidence of DGF with intraoperative verapamil administration in small case series. 16 , 18 However, kidney transplants in the current era use more expanded criteria donors (eg, older, DCD, longer CIT, elevated creatinine). A larger contemporaneous series comprised mainly living donor (39%) and DBD (58%) transplants failed to demonstrate a significant benefit with the use intraoperative verapamil.…”

Section: Discussionmentioning

confidence: 99%

“…19 Other studies have used intraoperative renal artery verapamil injection immediately postreperfusion in a single-pass model in an attempt to mitigate calcium-mediated IRI. 16,18,21 Intra-arterial verapamil significantly reduced the incidence of DGF in early reports. 16,18 A more recent single-center study failed to demonstrate that intraoperative verapamil reduced DGF.…”

Section: Introductionmentioning

confidence: 96%

“…16,18,21 Intra-arterial verapamil significantly reduced the incidence of DGF in early reports. 16,18 A more recent single-center study failed to demonstrate that intraoperative verapamil reduced DGF. 21 However, this latter study did observe that only 60% of the DCD Ver (+) group had DGF, in contrast to 80% in the DCD Ver (-) group.…”

Section: Introductionmentioning

confidence: 96%

See 3 more Smart Citations

Intraoperative Verapamil Fails to Reduce Delayed Graft Function in Donation After Circulatory Death Renal Allografts

Lovett

Stern

Weldon

et al. 2022

Transplantation Direct

View full text Add to dashboard Cite

Background. The shortage of transplantable organs has led to increased utilization of kidneys that may be particularly vulnerable to ischemia-reperfusion injury (IRI) and delayed graft function (DGF). Kidneys from donation after circulatory death (DCD) donors have additional IRI from donor procurement that results in increased risk of DGF. Verapamil may reduce IRI in kidney allografts when given at the time of organ reperfusion. This study sought to determine if intraoperative administration of verapamil (Ver) could reduce the risk of DGF in DCD kidney transplants. Methods. A single-center retrospective matched cohort study was performed of 93 Ver (–) kidney transplant recipients compared with 93 Ver (+) kidney transplant recipients, matched by donor age, Kidney Donor Profile Index, and DCD status. Covariates that could impact DGF risk were evaluated by univariate and multivariate logistic regression analyses. Results. The Ver (–) and Ver (+) matched cohorts did not have any significant differences in the demographic covariates. There was no difference in DGF rate between the Ver cohorts in either the overall study population or within the DCD subgroup. There was a trend toward reduced DGF in the Ver (+) cohort for cold ischemia time (CIT) ≤24 h, but this failed to achieve statistical significance. On multivariate analysis, only CIT was found to be independently associated with DGF. Conclusions. Intraoperative verapamil failed to reduce DGF risk in DCD kidney allografts. Limitations to this study include nonrandomization for the intraoperative administration of verapamil and the mean CIT >24 h in the study population. Only CIT was an independent prognosticator for DGF on multivariate analysis in a cohort matched for DCD status, consistent with prior studies.

show abstract

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 96%

See 2 more Smart Citations

Intraoperative Verapamil Fails to Reduce Delayed Graft Function in Donation After Circulatory Death Renal Allografts

Lovett

Stern

Weldon

et al. 2022

Transplantation Direct

View full text Add to dashboard Cite

show abstract

“…Finally, lidocaine [38], as membrane stabilizer, dexamethasone [39] as antiinflammatory, and verapamil [40] as external calcium channel blocker completed the full circle of all essential components used in the HBS solution.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Novel Cold Storage Solution (HBS) in a Rat Kidney Transplant Model

López-Neblina¹,

Toledo

Toledo‐Pereyra

2007

Journal of Investigative Surgery

View full text Add to dashboard Cite

We developed an improved solution for hypothermic storage (0-4 degrees C) of kidneys. The cold storage solution (HBS) was composed of macromolecules, high-energy cellular substrates, and a mixture of antiproteolytic amino acids, antioxidants, and anti-inflammatory compounds. The objectives in developing this solution were to achieve superior metabolic support of the kidney during cold storage and to protect against ischemic injury. Inbred Brown Norway rats, weighing 225-250 g, were subjected to orthotopic ultrarapid technique for kidney isotransplantation to minimize warm ischemia and to test the preservation process. The kidney was transplanted after 12 h of preservation. The animals were divided into three groups based upon the preservation solution utilized: HBS solution, HTK solution (Custodiol), and UW solution (UWS)(ViaSpan). Among the recipients, each group had two subsets. The first subset of animals was used to assess survival at 7 days as well as the reperfusion damage index (RDI) based on the macroscopic physical characteristics of the kidney at the time of transplantation. The second subset in each group was utilized to measure serum creatinine and blood urea nitrogen at 4 and 7 days, and histology at death or sacrifice. Mean +/- standard deviation (M +/- SD) was used for all parameters studied. The HBS solution showed significantly better protection at 12 h when compared to HTK and UW solutions. The reperfusion damage index (RDI) showed excellent preservation in the HBS (14 +/- 1), good preservation in UWS (13 +/- 1.5), and moderate preservation in the HTK (11 +/- 2) group. Histology was in concordance with the RDI, showing better histological findings with HBS and UW solutions than with the HTK group. Serum creatinine was significantly better in the HBS group when compared to HTK and UWS. Survival was statistically different, with 80% survival at 7 days in the HBS group, 20% survival in the HTK group, and 50% survival in the UWS group (p < .05). The HBS solution offered a new alternative for kidney cold storage with significantly better results when compared to the current gold standards of HTK and UW solutions in Brown Norway rats. This solution warrants further testing in other mammals.

show abstract

Renal Transplantation in Children

Winterberg¹,

Warshaw²

2014

Kidney Transplantation–Principles and Practice

View full text Add to dashboard Cite

Transoperative renal intraarterial verapamil in kidney transplantation decreases acute tubular necrosis

Cited by 5 publications

References 3 publications

Intraoperative Verapamil Fails to Reduce Delayed Graft Function in Donation After Circulatory Death Renal Allografts

Intraoperative Verapamil Fails to Reduce Delayed Graft Function in Donation After Circulatory Death Renal Allografts

Evaluation of a Novel Cold Storage Solution (HBS) in a Rat Kidney Transplant Model

Renal Transplantation in Children

Contact Info

Product

Resources

About