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

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Bibliographic Details
Title: Impact of an intra-abdominal cooling device during open kidney transplantation in pigs.
Authors: Longchamp, A., Meier, RPH, Colucci, N., Balaphas, A., Orci, L.A., Nastasi, A., Longchamp, G., Moll, S., Klauser, A., Pascual, M., Lazeyras, F., Corpataux, J.M., Bühler, L.
Publication Year: 2025
Collection: Université de Lausanne (UNIL): Serval - Serveur académique lausannois
Subject Terms: Abdominal Cavity, Animals, Body Temperature, Hypothermia, Induced/instrumentation, Kidney/pathology, Kidney Transplantation/methods, Models, Animal, Postoperative Period, Reperfusion Injury/prevention & control, Robotic Surgical Procedures, Swine, Urine, Warm Ischemia
Description: 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. 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. 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). 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.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 1424-3997
Relation: Swiss Medical Weekly; https://iris.unil.ch/handle/iris/198036; serval:BIB_CDAD0E3A442A; 000504461600001
DOI: 10.4414/smw.2019.20143
Availability: https://iris.unil.ch/handle/iris/198036
https://doi.org/10.4414/smw.2019.20143
Accession Number: edsbas.9CC5A38
Database: BASE
Description
Abstract: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. 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. 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). 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.
ISSN:14243997
DOI:10.4414/smw.2019.20143