Short-term arterial blood reperfusion of normothermic kidney in renal artery and abdominal aorta reconstructive surgery

Eur J Vasc Endovasc Surg. 2001 Apr;21(4):314-9. doi: 10.1053/ejvs.2001.1337.

Abstract

Objective: to prevent kidney injury in renal artery and juxta-renal aortic surgery. After 30 min of cross-clamping ischaemia, renal arterial inflow is temporary re-established for 3 min. The aim of the study was to retrospectively analyse the results of this original technique.

Methods: between January 1987 and May 1999, 48 patients underwent kidney short-term arterial blood reperfusion, directly or through the Pruitt-Inahara shunt. The reperfusion was repeated every 30 min of ischaemia, whenever necessary. Fifty control patients underwent <30 min of kidney ischaemia. Patients were assessed by serum creatinine, digital angiography and radioisotope renography using technecium(99).

Results: in the study group one patient developed an acute renal failure and died (2% (-95% CI: 0-11%)). In both study and control groups patients showed a similar and moderate but temporary decline in renal function, which returned to preoperative levels after 1 week.

Conclusions: the results of this study indicate that kidney short-term reperfusion may protect renal tissue from prolonged cross-clamping ischaemia (up to 100 min), also in patients considered at high risk for acute renal failure.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography
  • Aorta, Abdominal / surgery*
  • Creatinine / metabolism
  • Female
  • Humans
  • Kidney / blood supply*
  • Kidney / physiopathology*
  • Male
  • Middle Aged
  • Plastic Surgery Procedures
  • Renal Artery / surgery*
  • Reperfusion Injury / physiopathology*
  • Reperfusion Injury / prevention & control*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Creatinine