Vein “Beltization” Technique Facilitates Venous Anastomoses for Laparoscopic Orthotopic Kidney Transplantation in a Pig Model

Han, Xiao; Zhao, Yongwei; Zhu, Xuhui; Li, T.; Li, Y.; Zhang, P.; Chen, Y.; Li, G.; Zhang, X.; He, Bulang

doi:10.1016/j.transproceed.2019.01.034

Cited by 3 publications

(8 citation statements)

References 12 publications

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“…The pig was moved to the left lateral position for implanting of the left kidney to the right kidney position after nephrectomy. Normally, four trocars are placed on the right side of the abdominal wall with the original incision under manual guidance, similar to previous reports (8,9). Specifically, the first trocar, which was 5.5 mm, was located 2 cm above the junction between the iliac crest and the midaxillary line.…”

Section: Laparoscopic Orthotopic Kidney Autotransplantationmentioning

confidence: 89%

“…A total of 20 swine provided by Beijing Tonghe Litai Biotechnology Co., Ltd. were available for a LOKT trial to assess the safety and reliability of the organ cooling system. The animals were divided into three groups: 8 in the cooling jacket group using the controllable DCD for hypothermia (DCD group), 8 in the silicon tube cage [STC; as we previously described a device for LOKT (8,9)] group using the STC for hypothermia (STC group) and four in the control group involving no hypothermia measures (NH group).…”

Section: Animals and Preparationmentioning

confidence: 99%

“…Immediately after the donor kidney was removed, lavage was completed with 4 ℃ perfusion fluids. Then, the renal vein was belted, meaning that the dissected edge of the renal vein was sutured circumferentially with a 5-0 Prolene thread, and a knot was tied to maintain the renal vein at the maximum diameter, as previously reported (9). The donor kidney was then placed in the cooling device (or not, according to the group) and refrigerated in ice water for later use.…”

Section: Nephrectomymentioning

confidence: 99%

“…Therefore, a reliable intracorporeal cooling device should be researched and developed. In recent years, we have conducted experimental research on LOKT and designed cooling equipment for laparoscopic organ transplantation (8,9). Based on previous designs, after refinement and improvement, we recently designed a safer and more effective cooling setting, a controllable double-cycle cryogenic device (DCD; patented in China, patent No.…”

Section: Introductionmentioning

confidence: 99%

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A controllable double-cycle cryogenic device inducing hypothermia for laparoscopic orthotopic kidney transplantation in swine

et al. 2021

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Background: It is necessity to maintain donor kidneys at a low temperature for laparoscopic orthotopic kidney transplantation (LOKT). We recently designed a controllable double-cycle cryogenic device (DCD) with a safer and more effective cooling setting. This study aimed to evaluate the safety and efficacy of this device in a swine model.Methods: A total of 20 pigs were procured for this study. We performed LOKT on 8 pigs using the controllable DCD for hypothermia, on another 8 pigs using the silicon tube cage (STC) for hypothermia, and on 4 pigs as the control group with no hypothermia measures (NH). The LOKTs were performed in autotransplantation mode in which the right kidney vein and artery were end-to-end anastomosed to the left kidney vein and artery in all three groups. The perioperative data, graft temperatures, and surgical complications were recorded, and histological examinations of kidney specimens were performed. Results:The average surface temperature in the DCD group (5±3.5 ℃) was significantly lower than that in the STC (10±5.5 ℃) and NH (28±3.0 ℃) groups. In the DCD and STC groups, the temperature between the cooling setting and the adjacent peritoneum was 30±3.0 and 12±5.0 ℃, respectively. All pigs survived for 7 days in the DCD group. In the STC group, 2 pigs died from liver lesions and other causes. A single pig had diabetes insipidus. No pigs survived for 7 days in the NH group. The specimens from pigs immediately after revascularization and from the surviving pigs on day 7 following transplantation showed that the morphology of the glomerular and renal tubules was largely normal in the DCD and STC groups. However, in the NH group, there was minimal interstitial and tubular oedema, and endothelial cell swelling occurred in some specimens immediately after revascularization. Pathological examination of the harvested graft specimens showed severe acute tubular necrosis in the NH group. Conclusions:The newly designed controllable DCD can achieve the goal of cooling the kidney and warming the patient and may be a reliable, effective, inexpensive, and practical hypothermic maintenance system for LOKT in swine.

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Section: Laparoscopic Orthotopic Kidney Autotransplantationmentioning

confidence: 89%

Section: Animals and Preparationmentioning

confidence: 99%

Section: Nephrectomymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A controllable double-cycle cryogenic device inducing hypothermia for laparoscopic orthotopic kidney transplantation in swine

et al. 2021

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“…LOKT requires not only reliable intraoperative cooling measures to ensure the hypothermia and good function of the transplanted kidney, but also reliable vascular anastomosis techniques to ensure the anastomosis quality of the transplanted kidney vascular and good blood supply. During our previous study, we found that the most difficult procedure associated with LOKT was renal-vein anastomosis (6,7,12). Based on the experience of a large number of animal experiments, we designed a novel vascular prop device that can help to open the veins of the kidney, facilitate vascular anastomosis, greatly improve the speed and quality of vein anastomosis, and improve the success rate of LOKT.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Orthotopic Kidney Transplantation in Swine: A Novel Vascular Prop Device for Venous Anastomoses

et al. 2021

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Objective: To investigate the safety and efficacy of a vascular prop device for laparoscopic orthotopic kidney transplantation (LOKT) in swine.Material and Methods: Twenty swine were randomly divided into two groups. A vascular prop device was used in the observation (VP) group, and the vein beltization technique was used in the control (VB) group. The right kidney, as a donor graft, was laparoscopically transplanted to the location of the left kidney after a left nephrectomy. Data on the operative time, venous anastomotic time, vein stenosis, etc., and the survival of the swine in the two groups were recorded.Results: The mean transplant operative time, the mean cold ischemia time, and the venous anastomotic times in the VP group were significantly shorter than those in the VB group. Seven swine in the VP group and three swine in the VB group survived for 7 days. Autopsy results showed the occurrence of one artery stenosis and one vein stenosis in the VP group and one artery stenosis and five vein stenoses in the VB group. The median survival time was 6.25 days for the swine in the VP group and 4.40 days for those in the VB group.Conclusions: The vascular prop device is safe and feasible for LOKT in swine and may accelerate venous anastomosis and ensure the quality of venous anastomotic stoma.

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An Effective Cooling Device for Minimal-Incision Kidney Transplantation

Han

Dagvadorj³

et al. 2020

Ann Transplant

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Background This study investigated the safety and efficacy of a new cooling device for use in minimal-incision kidney transplantation (MIKT). Material/Methods From June 2016 to December 2021, 9 patients underwent MIKT surgery in our hospitals using the new cooling device to maintain hypothermia. We recorded and analyzed information on the etiology, comorbid status, ongoing renal replacement assessment, BMI, HLA mismatching sites of donors and recipients, and perioperative and postoperative clinical data for recipients. Results Kidney transplantation was successfully performed in all patients. The kidney surface temperature measurement results showed that the intraoperative renal anterior and posterior surface temperatures were stable at approximately 3.8±1.2°C and 5.2±1.3°C, respectively, during ice-water circulation. The mean operation time was 112±15 min, the artery anastomosis time was 16±6.0 min, and the vein anastomosis time was 14±4.5 min. All recipients recovered uneventfully. The patients were followed up for 6–30 months. Urinary and vascular complications were not found in any recipients. Conclusions The new cooling device can facilitate MIKT. It is safe and feasible to carry out MIKT using the new cooling device, which can reduce surgical trauma and improve the quality of vascular anastomosis with satisfactory cosmetic results.

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Vein “Beltization” Technique Facilitates Venous Anastomoses for Laparoscopic Orthotopic Kidney Transplantation in a Pig Model

Cited by 3 publications

References 12 publications

A controllable double-cycle cryogenic device inducing hypothermia for laparoscopic orthotopic kidney transplantation in swine

A controllable double-cycle cryogenic device inducing hypothermia for laparoscopic orthotopic kidney transplantation in swine

Laparoscopic Orthotopic Kidney Transplantation in Swine: A Novel Vascular Prop Device for Venous Anastomoses

An Effective Cooling Device for Minimal-Incision Kidney Transplantation

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