Histological changes in neonatal kidneys after cardiopulmonary bypass and deep hypothermic circulatory arrest.
BACKGROUND
Renal failure after open-heart surgery is a serious complication resulting in increased mortality and morbidity. The aim of the study was to find out whether different strategies for open-heart surgery would result in renal histological differences in a neonatal animal model.


METHODS
The renal tissue of newborn piglets was examined after mild hypothermic cardiopulmonary bypass (CPB group; n = 10), deep hypothermic circulatory arrest (DHCA group; n = 8), instrumentation without extracorporeal circulation (sham; n = 3), and the data were compared with those of normal porcine neonatal kidneys (control; n = 6). The severity of tissue damage was graded using a 4-point scoring system (0: normal morphology, 3: severe damage). Apoptotic cells and granulocytes were counted.


RESULTS
The histological score was higher in all groups compared with controls ( P < 0.05) and higher in the CPB group compared with the DHCA group ( P < 0.05). More apoptotic cells and granulocytes were found in the CPB group compared with controls and the DHCA group ( P < 0.05).


CONCLUSIONS
Although changes in the kidney tissue of newborn piglets are detectable after any cardiac procedure, changes are more profound after cardiopulmonary bypass with mild hypothermia.
Tirilomis
T
T
Thoracic, Cardiac, and Vascular Surgery, University of Göttingen, Göttingen, Germany. theodor.tirilomis@med.uni-goettingen.de
Tempes
T
T
Waldmann-Beushausen
R
R
Ballat
C
C
Bensch
M
M
Schoendube
F A
FA
D000818:Animals; D000831:Animals, Newborn; D017209:Apoptosis; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D050792:Circulatory Arrest, Deep Hypothermia Induced / Q000009:adverse effects*; D006098:Granulocytes / Q000473:pathology*; D007668:Kidney / Q000473:pathology*; D023421:Models, Animal; D051437:Renal Insufficiency / Q000209:etiology / Q000473:pathology*; D012720:Severity of Illness Index; D013552:Swine