Glomerular Morphology and Renal Function after Warm Ischemia by Main Artery or Selective Clamping in a Porcine Model

2017 ◽  
Vol 99 (3) ◽  
pp. 262-266 ◽  
Author(s):  
Gustavo R. Bechara ◽  
José A. Damasceno-Ferreira ◽  
Leonardo A.S. Abreu ◽  
Waldemar S. Costa ◽  
Francisco J.B. Sampaio ◽  
...  
Keyword(s):  
Renal Function ◽  
Porcine Model ◽  
Warm Ischemia ◽  
Main Artery ◽  
Glomerular Morphology

scholarly journals Role of warm ischemia on innate and adaptive responses in a preclinical renal auto-transplanted porcine model

2013 ◽  
Vol 11 (1) ◽  
pp. 129 ◽  
Author(s):  
Ludivine Rossard ◽  
Frédéric Favreau ◽  
Sebastien Giraud ◽  
Raphael Thuillier ◽  
Sylvain Le Pape ◽  
...  
Keyword(s):  
Porcine Model ◽  
Warm Ischemia ◽  
Adaptive Responses

scholarly journals Extracorporeal resuscitation with carbon monoxide improves renal function by targeting inflammatory pathways in cardiac arrest in pigs

2019 ◽  
Vol 317 (6) ◽  
pp. F1572-F1581 ◽  
Author(s):  
Jakob Wollborn ◽  
Bjoern Schlueter ◽  
Christoph Steiger ◽  
Cornelius Hermann ◽  
Christian Wunder ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Renal Function ◽  
Cardiac Arrest ◽  
Renal Injury ◽  
Porcine Model ◽  
Life Support ◽  
Apoptotic Cell ◽  
Extracorporeal Life Support ◽  
Successful Resuscitation ◽  
Extracorporeal Resuscitation

Deleterious consequences like acute kidney injury frequently occur upon successful resuscitation from cardiac arrest. Extracorporeal life support is increasingly used to overcome high cardiac arrest mortality. Carbon monoxide (CO) is an endogenous gasotransmitter, capable of reducing renal injury. In our study, we hypothesized that addition of CO to extracorporeal resuscitation hampers severity of renal injury in a porcine model of cardiac arrest. Hypoxic cardiac arrest was induced in pigs. Animals were resuscitated using a conventional [cardiopulmonary resuscitation (CPR)], an extracorporeal (E-CPR), or a CO-assisted extracorporeal (CO-E-CPR) protocol. CO was applied using a membrane-controlled releasing system. Markers of renal injury were measured, and histopathological analyses were carried out. We investigated renal pathways involving inflammation as well as apoptotic cell death. No differences in serum neutrophil gelatinase-associated lipocalin (NGAL) were detected after CO treatment compared with Sham animals (Sham 71 ± 7 and CO-E-CPR 95 ± 6 ng/mL), while NGAL was increased in CPR and E-CPR groups (CPR 135 ± 11 and E-CPR 124 ± 5 ng/mL; P < 0.05). Evidence for histopathological damage was abrogated after CO application. CO increased renal heat shock protein 70 expression and reduced inducible cyclooxygenase 2 (CPR: 60 ± 8; E-CPR 56 ± 8; CO-E-CPR 31 ± 3 µg/mL; P < 0.05). Caspase 3 activity was decreased (CPR 1,469 ± 276; E-CPR 1,670 ± 225; CO-E-CPR 755 ± 83 pg/mL; P < 0.05). Furthermore, we found a reduction in renal inflammatory signaling upon CO treatment. Our data demonstrate improved renal function by extracorporeal CO treatment in a porcine model of cardiac arrest. CO reduced proinflammatory and proapoptotic signaling, characterizing beneficial aspects of a novel treatment option to overcome high mortality.

scholarly journals Sutureless laparoscopic partial nephrectomy using fibrin gel reduces ischemia time while preserving renal function

2019 ◽  
Vol 91 (1) ◽  
pp. 30-34 ◽  
Author(s):  
Daniele Tiscione ◽  
Tommaso Cai ◽  
Lorenzo Giuseppe Luciani ◽  
Marco Puglisi ◽  
Daniele Mattevi ◽  
...  
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Kidney Function ◽  
Charlson Comorbidity Index ◽  
Operative Time ◽  
Warm Ischemia ◽  
Control Group ◽  
Fibrin Gel ◽  
Ischemia Time ◽  
Comorbidity Index

Objectives: We evaluated the efficacy of sutureless laparoscopic partial nephrectomy (LPN), using a fibrin gel in order to minimize renal ischemia time and preserve kidney function. Materials and Methods: Nineteen patients (mean age 58.3 ± 7.1) undergoing sutureless LPN using a fbrin gel were compared with a control group consisting of 21 patients (mean age 57.9 ± 7.5) subjected to LPN with standard suturing. Intraand post-operative data for the two groups were compared. The following parameters were recorded: patient demographics, Charlson Comorbidity Index, tumor characteristics according to the RENAL score, warm ischemia and operative times, estimated blood loss, mean hospital stay, post-operative complications referring to the Clavien-Dindo classification, renal function parameters pathologic and follow-up data. The main outcome measure was renal ischemia time and maintenance of kidney function. Results: Median warm ischemia time was 13 minutes (range 11-19) in the group treated with fibrin gel and 19 (range 17- 29) in the control group, with a statistically significant difference (p < 0.001). The two groups were homogeneous in terms of the Charlson Comorbidity Index (4.6 vs 4.8) and RENAL score (9.6 vs 9.4). Median operative time differed significantly in the two groups, 183 minutes (range 145-218) in the group treated with fibrin gel and 201 (range 197-231) in the control group (p < 0.001). A negative surgical margin was reported in 18 patients (94.7%) in the group treated with fibrin gel and in 21 patients (100%) in the control group. No difference in renal function was found between the two groups. Conclusions: Sutureless LPN with fibrin gel can reduce warm ischemia and total operative time while preserving kidney function.

Erythropoietin-Induced Optimization of Renal Function After Warm Ischemia

2009 ◽  
Vol 23 (3) ◽  
pp. 359-365 ◽  
Author(s):  
Courtney K. Phillips ◽  
Gregory W. Hruby ◽  
Gabriella Mirabile ◽  
Piruz Motamedinia ◽  
Daniel S. Lehman ◽  
...  
Keyword(s):  
Renal Function ◽  
Warm Ischemia

Use of comparison of cold and warm ischemia during partial nephrectomy in 660 solitary kidneys to investigate the role of nonmodifiable factors in determining ultimate renal function.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 321-321
Author(s):  
B. R. Lane ◽  
P. Russo ◽  
R. Uzzo ◽  
A. V. Hernandez ◽  
S. A. Boorjian ◽  
...  
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Statistical Significance ◽  
Warm Ischemia ◽  
Ischemia Time ◽  
Solitary Functioning Kidney ◽  
Modifiable Factors ◽  
Multivariable Analyses ◽  
The Impact ◽  
Functioning Kidney

321 Background: Factors that determine renal function after partial nephrectomy (PN) are not well defined, including the impact of cold vs. warm ischemia and the relative importance of modifiable and non-modifiable factors. We studied these determinants in a large cohort of patients with a solitary functioning kidney undergoing PN. Methods: In 1980–2009, 660 PN were performed at 4 centers for tumor in a solitary-functioning kidney under cold (n=300) or warm (n=360) ischemia. Data were collected in IRB-approved registries; follow- up averaged 4.5 years. Pre- and postoperative glomerular filtration rates (GFR) were estimated via CKD-EPI equation. Results: At 3 months after PN, median GFR decreased by equivalent amounts with cold or warm ischemia (21% vs. 22%, respectively, p=0.7) although median cold ischemic times were much longer (45 vs. 22 min. respectively, p<0.001). In multivariable analyses, increasing age, larger tumor size, lower preoperative GFR, and longer ischemia time were associated with decreased postoperative GFR (p<0.05). When percentage of parenchyma spared was incorporated into the analysis, this factor and preoperative GFR proved to be the primary determinants of ultimate renal function, and duration of ischemia lost statistical significance. Conclusions: This non-randomized comparative study suggests that long-term renal function after PN is determined primarily by the quantity and quality of renal parenchyma that can be preserved. Within the relatively strict parameters of conventional practice, i.e. predominantly short ischemic intervals and liberal use of hypothermia, ischemia time was not an independent predictor of ultimate renal function after PN. Nevertheless, type and duration of ischemia remain the most important modifiable factors during PN, and mandate further study. [Table: see text]

RENAL TOLERANCE TO PROLONGED WARM ISCHEMIA TIME IN A LAPAROSCOPIC VERSUS OPEN SURGERY PORCINE MODEL

2004 ◽  
Vol 172 (6 Part 1) ◽  
pp. 2471-2474 ◽  
Author(s):  
BRETT A. LAVEN ◽  
MARCELO A. ORVIETO ◽  
MARC S. CHUANG ◽  
CHAD R. RITCH ◽  
PATRICK MURRAY ◽  
...  
Keyword(s):  
Open Surgery ◽  
Porcine Model ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Ischemia Time ◽  
Renal Tolerance
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