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

Longchamp, Alban; Meier, Raphael P. H.; Colucci, Nicola; Balaphas, Alexandre; Orci, Lorenzo A.; Nastasi, Antonio; Longchamp, Grégoire; Moll, Solange; Klauser, Antoine; Pascual, Manuel; Lazeyras, François; Corpataux, Jean-Marc; Bühler, Leo

doi:10.4414/smw.2019.20143

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Journal article

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

Longchamp, Alban Department of Vascular Surgery, Lausanne University Hospital and the University of Lausanne, Switzerland
Meier, Raphael P. H. Visceral and Transplant Surgery, Department of Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland / Transplant Surgery, University of California San Francisco, CA, USA
Colucci, Nicola Visceral and Transplant Surgery, Department of Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland
Balaphas, Alexandre Visceral and Transplant Surgery, Department of Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland
Orci, Lorenzo A. Visceral and Transplant Surgery, Department of Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland
Nastasi, Antonio Visceral and Transplant Surgery, Department of Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland
Longchamp, Grégoire Visceral and Transplant Surgery, Department of Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland
Moll, Solange Division of Clinical Pathology, Department of Pathology and Immunology, Geneva University Hospital and Medical School, Geneva, Switzerland
Klauser, Antoine Department of Radiology and Medical Informatics, University of Geneva, Switzerland
Pascual, Manuel Transplantation Centre, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
Lazeyras, François Department of Radiology and Medical Informatics, University of Geneva, Switzerland
Corpataux, Jean-Marc Department of Vascular Surgery, Lausanne University Hospital and the University of Lausanne, Switzerland
Bühler, Leo Faculty of Science and Medicine, Section of Medicine, University of Fribourg, Switzerland

23.12.2019

Published in:

Swiss Medical Weekly. - 2019, vol. 149, no. 5152, p. w20143

English 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.

Faculty

Faculté des sciences et de médecine

Department

Master en médecine

Language