Feuillu B, Cormier L, Frimat L, Coissard A, Mangin P, Hubert J
Service d'Urologie, CHU Nancy-Brabois, rue du Morvan, 54511 Vancoeuvre.
Prog Urol. 2001 Sep;11(4):631-5.
To describe kidney cooling during multi-organ harvesting (MOH) from brain-dead donors and to evaluate harvesting practices.
The temperature of 12 kidneys (6 left and 6 right kidneys) was monitored continuously during MOH from brain-dead donors. After in situ cooling, the kidneys were separated on the table and washed for several minutes with UW preservation solution. The kidney temperature was studied as a function of the main phases of the operative procedure.
The mean minimum kidney temperature of 10.8 degrees C (3.7 degrees C to 16.6 degrees C) was reached at the beginning of mobilization of the liver, i.e. an average of 20 minutes (13 to 37 min) after cannulation. The mean cooling rate was 1.37 degrees C/min (0.73 to 2.19 degrees C/min). The mean temperature of the UW cooling solution was 9.4 degrees C (3.8 degrees C to 14 degrees C). For hepatic followed by renal dissection, the kidneys slowly reheated at a mean rate of 0.20 degree C/min (0.12 to 0.37 degree C/min) to reach a mean temperature of 21 degrees C (13.5 degrees C to 26.3 degrees C) at the time of resection. The mean kidney temperature at the time of placement in the container was 17.5 degrees C (13.2 degrees C to 22 degrees C).
The course of kidney temperature during MOH has not been previously described. This study, performed under usual harvesting conditions, demonstrated sometimes imperfect cooling that could be harmful to he kidneys, but which could be improved by simple measures: rapid dissection of the liver and kidneys and correct application of contact cooling.
描述从脑死亡供体进行多器官获取(MOH)过程中肾脏的降温情况,并评估获取操作。
在从脑死亡供体进行MOH期间,连续监测12个肾脏(6个左肾和6个右肾)的温度。原位冷却后,在手术台上分离肾脏,并用UW保存液冲洗数分钟。研究肾脏温度与手术主要阶段的关系。
在肝脏游离开始时,平均最低肾脏温度达到10.8℃(3.7℃至16.6℃),即插管后平均20分钟(13至37分钟)。平均降温速率为1.37℃/分钟(0.73至2.19℃/分钟)。UW冷却溶液的平均温度为9.4℃(3.8℃至14℃)。对于先进行肝脏然后进行肾脏解剖的情况,肾脏以平均0.20℃/分钟(0.12至0.37℃/分钟)的速率缓慢复温,在切除时达到平均温度21℃(13.5℃至26.3℃)。放入容器时的平均肾脏温度为17.5℃(13.2℃至22℃)。
此前尚未描述过MOH过程中肾脏温度的变化过程。本研究在常规获取条件下进行,结果表明有时冷却不完美,可能对肾脏有害,但可通过简单措施加以改善:快速解剖肝脏和肾脏以及正确应用接触式冷却。