Warm ischemia time does not correlate with recip

Authors: M M Buzdon E Cho S C Jacobs B Jarrell J L Flowers

Publish Date: 2003/03/06

Volume: 17, Issue: 5, Pages: 746-749

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Abstract

Background Laparoscopic donor nephrectomy LDN has been shown to be a safe and effective option for renal procurement Studies comparing open nephrectomy and handassisted laparoscopy have emphasized decreased warm ischemia time when compared with “pure” laparoscopic retrieval However no data exist that define exactly what constitutes a prolonged warm ischemia time in terms of recipient graft function The aim of this study was to use a large singleinstitution experience with LDN to determine if warm ischemia time correlates with recipient graft function as measured by serum creatinine levels Methods A total of 640 LDNs were performed from March 1996 to August 2001 Warm ischemia times were prospectively collected and were defined as the time from renal artery occlusion to immersion in iced saline Serial recipient creatinine levels were measured at 1 week and 1 3 6 and 12 months when possible from the transplant Data were analyzed using Pearson correlation analysis at a confidence interval of 95 Results Mean warm ischemia time was 151 s with a standard error of 34 s and ranged from 35 to 720 s Recipient creatinine mean at 1 week was 194 mg/dl with a standard error of 006 mg/dl and ranged from 05 to 105 mg/dl Recipient creatinine mean at 1 month was 168 mg/dl with a standard error of 006 mg/dl and ranged from 06 to 85 mg/dl Recipient creatinine mean at 3 months was 160 mg/dl with a standard error of 004 mg/dl and ranged from 06 to 88 mg/dl Recipient creatinine mean at 6 months was 163 mg/dl with a standard error of 006 mg/dl and ranged from 07 to 135 mg/dl Recipient creatinine mean at 12 months was 170 mg/dl with a standard error of 007 mg/dl and ranged from 05 to 145 mg/dl No correlation was found between warm ischemia time and recipient creatinine levels at 1 week p = 04737 1 month p = 09180 3 months p = 06227 6 months p = 08349 or 12 months p = 02835 Conclusions Warm ischemia time does not correlate with recipient graft function in LDN within the range of times studied Shorter warm ischemia time associated with open donor nephrectomy and handassisted LDN does not necessarily offer a measurable advantage in recipient graft function During extraction of the kidney expediency to minimize warm ischemia time should not supersede controlled and safe maneuvers in renal vessel division and extraction of the kidney

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