Scientific article
Open access

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

Published inAmerican Journal of Transplantation, vol. 18, no. 1, p. 53-62
Publication date2018

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.

Citation (ISO format)
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
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Article (Accepted version)
ISSN of the journal1600-6135

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