A Novel Intra-Abdominal Cooling System Prevents Graft Warming During Implantation for Robotic-Assisted Renal Transplantation.
Visceral and Transplant Surgery, Department of Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland, Geneva, Switzerland.
Meeting: 2016 American Transplant Congress
Abstract number: C185
Keywords: Kidney, Reactive oxygen species
Session Information
Date: Monday, June 13, 2016
Session Name: Poster Session C: Kidney Transplantation: AKI/Preservation/DCD
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background and objective
Robotic kidney transplantation is minimal invasive and leads to decreased surgical site infection. In this stetting, warm ischemia time remains a valid concern. The purpose of this study was to compare robotic-assisted kidney transplantation to open surgery in a pig model with a particular focus on warm ischemia time control.
Methods
Pig kidneys were procured by open surgery, flushed with IGL-1 at 4⁰C, and the left kidney was transplanted to the same animal. Kidneys were transplanted using conventional open approach with classic local cooling with 4[deg]C saline solution (group 1) (n= 4) or robotic-assisted surgery (group 2) with either no cooling (n = 9) or cooling (n = 10) using a specific and newly designed water cooling system. Real-time temperature measure was performed using a cortical thermal probe prior to the procurement. At 6 hours after implantation, a magnetic resonance imaging with gadolinium injection was performed to measure the perfusion of the grafts.
Results
The mean time of implantation was 39.4 ±7.8 minutes for the open group and 68.6 ±8 minutes overall for the robotic cohorts (p=0.002). The temperature of the grafts at the end of implantation was 23.5±7 [deg]C for group 1, 29±2 [deg]C for group 2 and 12±5 [deg]C for group 3 (p=0.397 and 0.047 respectively). The gadolinium perfusion of the grafts and urine output was similar in all groups.
Conclusion
The use of robotic assisted renal transplantation prolongs implantation time and increases the warm ischemia of the graft. The use of a newly designed intra-abdominal cooling device significantly prevents warming of grafts during robotic implantation and keeps temperature levels lower than those observed with open surgery which might prevent warm ischemia damage. Further research is necessary to assess the effects of robotic techniques for kidney transplantation.
CITATION INFORMATION: Meier R, Hagen M, Joliat C, Buchs J.-B, Nastasi A, Ruttimann R, Lazeyras F, Morel P, Bühler L. A Novel Intra-Abdominal Cooling System Prevents Graft Warming During Implantation for Robotic-Assisted Renal Transplantation. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Meier R, Hagen M, Joliat C, Buchs J-B, Nastasi A, Ruttimann R, Lazeyras F, Morel P, Bühler L. A Novel Intra-Abdominal Cooling System Prevents Graft Warming During Implantation for Robotic-Assisted Renal Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/a-novel-intra-abdominal-cooling-system-prevents-graft-warming-during-implantation-for-robotic-assisted-renal-transplantation/. Accessed March 2, 2021.« Back to 2016 American Transplant Congress