TITLE:
Significance of Cold Renal Perfusion on Renal Function and Clinical Outcomes When Renal Ischemia Time Exceeded 30 Min during Pararenal and Juxtarenal Abdominal Aortic Aneurysm Surgery
AUTHORS:
Koji Furukawa, Kosuke Mori, Yukie Shirasaki, Hirohito Ishii, Kunihide Nakamura
KEYWORDS:
Cold Renal Perfusion, Pararenal Abdominal Aortic Aneurysm, Juxtarenal Abdominal Aortic Aneurysm, Suprarenal Clamping, Renal Function
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.9 No.9,
September
6,
2019
ABSTRACT:
Objectives: To investigate the influence of cold renal
perfusion on renal function and clinical outcomes in cases where the renal
ischemia time exceeded 30 min during pararenal and juxtarenal abdominal
aortic aneurysm (P/JAAA) surgery. Methods and Results: Fifty-four
patients who underwent open repair for P/JAAAs were retrospectively analyzed.
Thirty-nine patients received renal perfusion
with cold Ringer’s solution (perfusion group) and 15 patients did not receive
renal perfusion (non-perfusion group). There were no significant differences in
preoperative serum creatinine level (Cr) (1.08 ± 0.42 vs. 1.35 ± 0.71
mg/dL, p = 0.09), percentage of patients with Cr > 2 mg/dL [2/38 (5%) vs.
2/15 (13%), p = 0.8], and renal ischemia time during proximal aortic clamping
(49 ± 21 vs. 47 ± 11 min; p = 0.8) between the groups. Postoperative Cr was
significantly lower in the perfusion group than in the non-perfusion group
(1.48 ± 0.76 vs. 2.23 ± 1.21 mg/dL, p 2 mg/dL was also
significantly lower in the perfusion group than in the non-perfusion group [5
(13%) vs. 7 (47%), p Conclusion: Renal artery perfusion with cold
Ringer’s solution clearly reduced the deterioration
of postoperative renal function compared to non-renal perfusion.