Intra-abdominal cooling system limits ischemia-reperfusion injury during robot-assisted renal transplantation

Article Article scientifique Article Intra-abdominal cooling system limits ischemia-reperfusion injury during robot-assisted renal transplantation eng 2018 author Meier Raphaël 517526 author Piller Vincent 725447 author Hagen Monika 778019 author Joliat Charles 704617 author Buchs Jean-Bernard 649516 author Nastasi Antonio author Ruttimann Raphael author Buchs Nicolas 516487 author Moll Solange 28349 author Vallée Jean-Paul 0000-0001-7546-2013 29185 author Lazeyras François 512748 author Morel Philippe 22337 author Buehler Leo Hans 71923 53-62 10.1111/ajt.14399 28637093 1600-6135 Robot-assisted kidney transplantation is feasible; however, concerns have been raised about possible increases in warm ischemia times. We describe a novel intra-abdominal cooling system to continuously cool the kidney during the procedure. Porcine kidneys were procured by standard open technique. Groups were as follow: Robotic renal transplantation with (n=11) and without (n=6) continuous intra-abdominal cooling and conventional open technique with intermittent 4°C saline cooling (n=6). Renal cortex temperature, magnetic resonance imaging and histology were analyzed. Robotic renal transplantation required a longer operative time, either with or without the cooling system, compared to the open approach (70.4±17.7 min and 74.0±21.5 min vs. 49.4±12.4 min, p-values<0.05). The temperature was lower in the robotic group with cooling system compared to the open approach group (6.5±3.1°C vs. 22.5±6.5°C; p=0.002) or compared to the robotic group without the cooling system (28.7±3.3°C; p=0.133). MRI parenchymal heterogeneities and histologic ischemia-reperfusion lesions were more severe in the robotic group without cooling than in the cooled (open and robotic) groups. Robot-assisted kidney transplantation prolongs the warm ischemia time of the donor kidney. We developed a novel intra-abdominal cooling system that suppresses the non-controlled rewarming of donor kidneys during the transplant procedure and prevents ischemia-reperfusion injuries. This article is protected by copyright. All rights reserved. Dewey 617 57 Département de chirurgie 222 false 393 Analyse protéomique et Analyse génomique des maladies rénales 659 79 Chirurgie viscérale 104 1329 Chirurgie viscérale (HUG) 270 Cultures cellulaires et transplantations 519 284 Groupe Lazeyras Francois (IRM fonctionnelle et métabolique) 539 286 Imagerie cardiaque fonctionnelle 541 562 Transplantation et hépatologie 905 American Journal of Transplantation 18 1 42e73e18-3899-4f97-bfc1-436a38679022 Article (Accepted version) Public Meier_et_al-2017-American_Journal_of_Transplantation.pdf 450059 application/pdf openAccess Faculté de médecine / Section de médecine clinique / Département de chirurgie

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Intra-abdominal cooling system limits ischemia-reperfusion injury during robot-assisted renal transplantation	American Journal of Transplantation			2018	948	279

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Piller, Vincent