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The emergency in situ preservation of kidneys for transplantation
Insights
Kidneys from non-heart-beating donors are now viable for transplantation. In situ kidney preservation (ISP) using a double balloon triple lumen (DBTL) catheter cools kidneys before removal, improving outcomes.
Area of Science:
- Nephrology
- Transplantation Surgery
- Medical Devices
Background:
- Current organ donation practices primarily utilize heart-beating donors.
- Kidneys from non-heart-beating donors are typically deemed unsuitable due to expected ischemic damage.
Purpose of the Study:
- To evaluate the feasibility and outcomes of utilizing kidneys from non-heart-beating donors.
- To introduce and discuss the in situ kidney preservation (ISP) technique.
Main Methods:
- Utilized the double balloon triple lumen (DBTL) catheter for in situ kidney preservation.
- Cooled kidneys in situ prior to donor nephrectomy.
- Performed nephrectomy under optimal surgical conditions facilitated by ISP.
Main Results:
- ISP enables kidney retrieval from donors with permanent cardiac arrest.
- The technique allows for cooling and preservation of kidneys before surgical removal.
- Transplantation outcomes for kidneys harvested using ISP are discussed.
Conclusions:
- In situ kidney preservation (ISP) expands the donor pool by enabling kidney retrieval from non-heart-beating donors.
- The DBTL catheter facilitates effective in situ cooling and preservation.
- ISP offers a viable method for obtaining transplantable kidneys, improving surgical conditions and potentially patient outcomes.
Abstract:
It is current practice to only consider heart-beating donors as suitable for organ donation. Patients who have sustained a permanent cardiac arrest are believed to be unsuitable for kidney retrieval, in the knowledge that the kidneys will have received extensive ischemic damage. In situ kidney preservation (ISP), using the double balloon triple lumen (DBTL) catheter, offers the possibility of harvesting valuable kidneys from these, otherwise unsuitable, donors. With this technique human kidneys can be cooled in situ prior to the donor nephrectomy. During ISP, nephrectomy can be performed under optimal surgical conditions. In this report indications for ISP, insertion technique of the DBTL catheter, legal aspects, and transplantation outcome of kidneys harvested by means of ISP are discussed.