[Surgical methods of cadaver nephrectomy prior to kidney transplantation (author's transl)]. 1981

C C Abbou, and J P Berberian, and T Nebout, and P Romano, and J Auvert

Surgical technique during donor's binephrectomy is one of the most important parameters conditioning early success after kidney transplantation. Experimental studies showed that tractions on the renal pedicle during kidney removal had a detrimental effect upon renal cortical vascularization and subsequent kidney function. Cortical vasoconstriction is equivalent to acute warm ischemia and therefore impedes prolonged kidney preservation. The means of preventing such events are: administration of large volumes of intravenous saline to the donor, renal vasodilation during surgery with furosemide (8 mg/kg I.V.) repeatedly administered, continuous I.V. infusion of dopamine (less than 10 micrograms/kg/min) and last but not least, surgical technique. Renal pedicles should never be publed. Initial dissection of inferior vena cava, aorta and both renal pedicles is mandatory. Kidney dissection takes place at the very end of the operative procedure. In case of cardiocirculatory arrest, both kidneys are cooled in situ after retrograde cannulation of the aorta above the renal arteries with an indwelling probe inserted into the femoral artery in the groin. From January, 1876 to August 31, 1979, 83 cadavers have been operated upon according to these techniques. Warm ischemic time was less than 5 minutes in all cases. 85 kidneys have been sent to other kidney transplantation centers and 19 kidneys discarded. Sixty-two kidneys have been transplanted in our institution. Cold ischemic time ranged from 2 to 43 hours. Immediate post-transplant massive diuresis (greater than 2 ml/mn) was observed in all recipients but 3 (95%).

UI MeSH Term Description Entries
D009392 Nephrectomy Excision of kidney. Heminephrectomy,Heminephrectomies,Nephrectomies
D009926 Organ Preservation The process by which organs are kept viable outside of the organism from which they were removed (i.e., kept from decay by means of a chemical agent, cooling, or a fluid substitute that mimics the natural state within the organism). Organ Preservations,Preservation, Organ,Preservations, Organ
D002102 Cadaver A dead body, usually a human body. Corpse,Cadavers,Corpses
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014021 Tissue Preservation The process by which a tissue or aggregate of cells is kept alive outside of the organism from which it was derived (i.e., kept from decay by means of a chemical agent, cooling, or a fluid substitute that mimics the natural state within the organism). Preservation, Tissue,Preservations, Tissue,Tissue Preservations
D014184 Transplantation, Homologous Transplantation between individuals of the same species. Usually refers to genetically disparate individuals in contradistinction to isogeneic transplantation for genetically identical individuals. Transplantation, Allogeneic,Allogeneic Grafting,Allogeneic Transplantation,Allografting,Homografting,Homologous Transplantation,Grafting, Allogeneic
D016030 Kidney Transplantation The transference of a kidney from one human or animal to another. Grafting, Kidney,Renal Transplantation,Transplantation, Kidney,Transplantation, Renal,Kidney Grafting,Kidney Transplantations,Renal Transplantations,Transplantations, Kidney,Transplantations, Renal

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