Protection From Second Warm Ischemic Injury Using a Thermal Barrier Bag in Kidney Transplantation.

Area of Science:

• Transplantation immunology
• Surgical innovation
• Biomaterials science

Background:

• Warm ischemic injury during vascular anastomosis negatively impacts kidney transplant success.
• Maintaining graft temperature is crucial for preventing immediate and long-term complications.

Purpose of the Study:

• To evaluate the safety, feasibility, and efficacy of a pouch-type thermal barrier bag (TBB) in preserving kidney grafts during transplantation.
• To assess the impact of TBB on graft surface temperature and ischemic time.

Main Methods:

• A first-in-human clinical trial involving ten living-donor kidney transplant recipients.
• Kidney grafts were placed in a TBB during vascular anastomosis.
• Graft surface temperature was monitored using a noncontact infrared thermometer.

Main Results:

• No serious adverse events related to the TBB were observed in the ten participants.
• The median second warm ischemic time was 31 minutes.
• The median graft surface temperature at the end of anastomosis was 16.1 °C.

Conclusions:

• The thermal barrier bag (TBB) effectively maintains transplanted kidneys at a low temperature during vascular anastomosis.
• This preservation contributes to improved functional outcomes and stable transplant results.