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

Nastasi, Antonio
Ruttimann, Raphael
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Published in American journal of transplantation. 2018, vol. 18, no. 1, p. 53-62
Abstract 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.
PMID: 28637093
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Research groups Analyse protéomique et Analyse génomique des maladies rénales (659)
Chirurgie viscérale (104)
Chirurgie viscérale (HUG)
Cultures cellulaires et transplantations (519)
Groupe Lazeyras Francois (IRM fonctionnelle et métabolique) (539)
Imagerie cardiaque fonctionnelle (541)
Transplantation et hépatologie (905)
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MEIER, Raphaël et al. Intra-abdominal cooling system limits ischemia-reperfusion injury during robot-assisted renal transplantation. In: American Journal of Transplantation, 2018, vol. 18, n° 1, p. 53-62. doi: 10.1111/ajt.14399 https://archive-ouverte.unige.ch/unige:96373

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Deposited on : 2017-08-30

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