Short-term arterial blood reperfusion of normothermic kidney in renal artery and abdominal aorta reconstructive surgery.
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.
Deriu
G P
GP
Division of Vascular Surgery, Department of Medical and Surgical Sciences, Padua, Italy.
Grego
F
F
Lepidi
S
S
Antonello
M
M
Milite
D
D
Zaramella
M
M
Damiani
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001012:Aorta, Abdominal / Q000601:surgery*; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012077:Renal Artery / Q000601:surgery*; D015427:Reperfusion Injury / Q000503:physiopathology* / Q000517:prevention & control*; D012189:Retrospective Studies; D016896:Treatment Outcome
D003404:Creatinine