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Original article

Vol. 149 No. 5152 (2019)

Impact of an intra-abdominal cooling device during open kidney transplantation in pigs

  • Alban Longchamp
  • Raphael P.H. Meier
  • Nicola Colucci
  • Alexandre Balaphas
  • Lorenzo A. Orci
  • Antonio Nastasi
  • Grégoire Longchamp
  • Solange Moll
  • Antoine Klauser
  • Manuel Pascual
  • François Lazeyras
  • Jean-Marc Corpataux
  • Leo Bühler
DOI
https://doi.org/10.4414/smw.2019.20143
Cite this as:
Swiss Med Wkly. 2019;149:w20143
Published
23.12.2019

Summary

BACKGROUND

Transplantation of kidneys from deceased donors is still associated with a high rate of postoperative renal dysfunction. During implantation into the recipient, the kidney rewarms. This second warm ischaemia time, which is not monitored, is harmful especially if prolonged. We recently developed an intra-abdominal cooling device that efficiently prevents kidney rewarming during robotic transplantation, and prevents ischaemia-reperfusion injuries. We tested the benefits of this cooling device during open kidney transplantation in pigs.

METHODS

Kidneys were procured from large pigs by open bilateral nephrectomy. Following procurement, kidneys were flushed with 4°C Institut Georges Lopez-1 preservation solution, and placed on ice. Animals then underwent double sequential autologous open renal transplantation with (n = 7) and without (n = 6) intra-abdominal cooling.

RESULTS

Mean anastomosis time was similar between groups (43.9 ± 13 minutes). At reperfusion, the renal cortex temperature was lower in the group with cooling (4.3 ± 1.1°C vs 26.5 ± 5.5°C, p <0.001). The cooled kidneys tended to be protected from injury, including some histopathological ischaemia-reperfusion lesions. With the device, kidneys had a better immediate postoperative urine output (p = 0.05).

CONCLUSION

Our results indicate that the intra-abdominal cooling device significantly reduced second warm ischaemic time during transplantation, is technically safe and does not prolong anastomotic time.

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