title: Renal Transplantation by Automatic Anastomotic Device in a Porcine Model.
abstract: Automatic vascular staplers for vascular anastomoses in kidney transplantation may dramatically reduce the operative time and, in particular, warm ischemia time, thus increasing the outcome of transplantation. Ten pigs underwent kidney auto-transplantation by automatic anastomotic device. Kidneys were collected by laparotomy with selective ligations at the renal hilum and perfused with cold storage solution. To overcome the shortage in length of renal hilum, a tract of the internal jugular vein was harvested to increase the length of the vessels. The anastomoses were totally performed by the use of the anastomotic device. On 10 kidney transplants, nine were successful and no complications occurred. Renal resistive indexes showed a slight increase in the immediate postoperative period returning normal at 10 days of follow-up. We demonstrated the possibility to perform renal vascular anastomoses by means of an automatic anastomotic device. This instrument developed for coronary bypass surgery by virtue of the small caliber of the vessels could be adopted on a larger scale for renal transplantation. The reduced warm ischemia time needed for anastomosis may help to achieve a better outcome for the graft and expand the pool of marginal donors in renal transplantation.
authors.affiliation: Department of Surgical, Oncological, and Stomatological Disciplines, University of Palermo, Palermo, Italy.
authors.forename: Attilio Ignazio
authors.initials: AI
authors.lastname: Lo Monte
authors.affiliation: Department of Surgical, Oncological, and Stomatological Disciplines, University of Palermo, Palermo, Italy.
authors.forename: Giuseppe
authors.identifier: http://orcid.org/0000-0002-9844-2434
authors.initials: G
authors.lastname: Damiano
authors.affiliation: Department of Surgical, Oncological, and Stomatological Disciplines, University of Palermo, Palermo, Italy.
authors.forename: Vincenzo Davide
authors.initials: VD
authors.lastname: Palumbo
authors.affiliation: Department of Surgical, Oncological, and Stomatological Disciplines, University of Palermo, Palermo, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Spinelli
authors.affiliation: Department of Surgical, Oncological, and Stomatological Disciplines, University of Palermo, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Buscemi
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D001331:Automation / Q000379:methods; D004195:Disease Models, Animal; D005260:Female; D007083:Iliac Artery / Q000033:anatomy & histology / Q000601:surgery; D007668:Kidney / Q000098:blood supply / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods*; D012077:Renal Artery / Q000033:anatomy & histology / Q000601:surgery; D013552:Swine
keywords: Anastomosis device; Kidney transplantation; Mechanical vascular sutures; Vascular anastomosis; Warm ischemia time