Evaluation of the effects of ischemic injury and ureteral obstruction on delayed graft function in cats after renal autotransplantation.
OBJECTIVE
To determine the relative importance of ischemic injury to delayed graft function (DGF) in cats.


METHODS
Experimental study.


METHODS
Six intact female cats.


METHODS
Cats had renal autograft transplantation without ureteral transection and reimplantation and a contralateral nephrectomy. Serum creatinine and blood urea nitrogen (BUN) concentrations were measured regularly and abdominal ultrasound was performed before surgery, the day after surgery and twice weekly thereafter. Ultrasound-guided renal biopsy was performed on day 7. Cats were euthanatized on day 21. Histology of the autograft, ureter, bladder, vascular anastomoses sites, and contralateral kidney were performed. Observations were compared with those from an historic group of research cats that had extravesicular ureteroneocystostomy and contralateral nephrectomy.


RESULTS
Five cats completed the study. Serum creatinine and BUN concentrations increased after surgery, peaking at 3.2+/-0.8 and 77.6+/-15.9 mg/dL, respectively, 1-2 days after surgery. Serum creatinine concentration returned to the reference interval by 6 days after surgery. BUN gradually decreased in all cats but did not return to the reference interval by study end. Serum creatinine and BUN concentrations were consistently lower but not significantly so (P=.29 and .56, respectively) compared with the historic ureteroneocystostomy group. No ultrasonographic abnormalities or renal biopsy histologic abnormalities were observed. At necropsy, 1 autograft had generalized interstitial fibrosis.


CONCLUSIONS
Harvesting the renal graft and the ischemia before revascularization causes impaired renal function after engraftment.


CONCLUSIONS
The process of harvesting and reimplanting the renal graft can contribute to DGF in cats, independent of ureteral obstruction.
Mehl
Margo L
ML
Department of Surgical and Radiological Sciences, Veterinary Medical Teaching Hospital, University of California-Davis, Davis, CA 95616, USA. mmehl@ucdavis.edu
Kyles
Andrew E
AE
Reimer
S Brent
SB
Flynn
Alison K
AK
Pollard
Rachel E
RE
Nyland
Tom
T
Kass
Philip H
PH
Griffey
Stephen M
SM
Gregory
Clare R
CR
D000818:Animals; D001806:Blood Urea Nitrogen; D002371:Cat Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002415:Cats; D003404:Creatinine / Q000097:blood; D051799:Delayed Graft Function / Q000662:veterinary*; D005260:Female; D007511:Ischemia / Q000662:veterinary*; D007668:Kidney / Q000098:blood supply* / Q000000981:diagnostic imaging; D016030:Kidney Transplantation / Q000379:methods / Q000662:veterinary*; D011183:Postoperative Complications / Q000662:veterinary; D014463:Ultrasonography; D014517:Ureteral Obstruction / Q000662:veterinary*
D003404:Creatinine