Protection of the renal artery in nephron-sparing surgery. I. Pathomorphological study

It is necessary to clamp the renal artery for some time in renal surgery to preserve the organ. Not only the renal parenchyma but also the wall of the clamped renal artery may be damaged due to known ischaemic-reperfusion causes. Regional venous renal hypothermia induced by intracellular solutions (Sacks II, Euro-Collins) could provide protection against damage of the vessel wall caused by reperfusion or clamping in our experiments, in cases of clamping for 30 minutes, probably because it also ensured the cooling of the surface of the vessel wall. Similar vasoprotective effect could be achieved by systematic antioxidant treatment (MTDQ-DS) and regional renal hypothermia given in combination. Harmful effects of 45-minute clamping could be best avoided by applying antioxidant treatment alone. While there were no significant morphological changes in the renal arteries the persistent endothelial damage may trigger further complications like renal ischaemic condition.