A Novel Cooling Device for Kidney Transplant Surgery.

Area of Science:

• Nephrology
• Transplant Surgery
• Biomedical Engineering

Background:

• Prolonged warm ischemia time (WIT) in kidney transplantation correlates with adverse outcomes like delayed graft function and reduced survival.
• Maintaining renal hypothermia and efficient vascular anastomosis are crucial for mitigating WIT during surgery.
• Existing intra-operative renal cooling methods have practical limitations and lack widespread adoption.

Purpose of the Study:

• To introduce and evaluate a novel device engineered for maintaining renal hypothermia during kidney transplant procedures.
• To assess the device's efficacy in cooling and supporting renal allografts in an ex-vivo setting.

Main Methods:

• A serpentine aluminum tubing cooling jacket was designed for malleable, form-fitting renal allograft manipulation.
• Adult porcine kidneys were used to test the device with 4°C saline coolant, monitoring surface and core temperatures.
• Ex-vivo anastomosis of porcine kidney vessels to vascular grafts was performed to evaluate device functionality.

Main Results:

• The device successfully maintained renal allograft surface and core temperatures at or below 5°C after 60 minutes of WIT.
• The cooling jacket provided hands-free retraction and support for the allograft.
• Ex-vivo anastomosis procedures were enhanced by the presence of the cooling jacket.

Conclusions:

• This proof-of-concept study validates the novel device as a practical tool for kidney transplantation.
• The device can maintain hypothermic graft temperatures, offering a potential solution to mitigate WIT.
• This innovative device has the potential to enhance kidney transplant outcomes by addressing WIT during graft implantation.