Document Detail


Arterial injury during perfusion preservation: a possible cause of posttransplantation renal artery stenosis.
MedLine Citation:
PMID:  7006135     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate the effect of perfusion preservation upon renal arteries, 10 sets of porcine kidneys were removed en bloc and flushed in iced Sacks' solution via an aortic cannula. Preservation at 4 degrees C was by ice storage without perfusion (10 kidneys), perfusion with cannulation of the aortic segment (five kidneys), or perfusion with direct cannulation of the renal artery (five kidneys). After 48 to 72 hours the renal arteries and their primary branches were examined histologically. No intimal changes were evident by light microscopy. By scanning electron microscopy the endothelium of all renal arteries preserved by ice storage or aortic perfusion remained intact with only occasional deposits of particulate matter. By contrast, three distinct lesions appeared in all arteries subjected to direct cannulation: (1) full-thickness crushing at the site of the securing ligature, (2) intimal flattening at the site of contact with the cannula, and (3) marked disruption of intimal architecture extending several millimeters beyond the cannula tip. The latter injury, presumably caused by turbulent flow, is not apparent to the unaided eye. If this abnormal intima is not adequately excised at the time of transplantation, fibrin and platelet deposition may lead to fibrosis and localized arterial stenosis. The injury can be avoided by ice storage or by indirect perfusion via an aortic cannula.
Authors:
D D Oakes; E K Spees; H A McAllister; W Saddler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  89     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1981 Feb 
Date Detail:
Created Date:  1981-03-24     Completed Date:  1981-03-24     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  210-5     Citation Subset:  AIM; IM    
Export Citation:
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MeSH Terms
Descriptor/Qualifier:
Animals
Catheterization / adverse effects*
Kidney Transplantation*
Organ Preservation*
Postoperative Complications*
Renal Artery / injuries*
Renal Artery Obstruction / etiology*
Swine
Tissue Preservation*
Transplantation, Homologous

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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