Low-dose In Situ Perfusion With Euro-Collins Solution Is Effective for the Procurement of Marginal Kidney Grafts From Donation After Circulatory Death Donors

2019 ◽  
Vol 51 (8) ◽  
pp. 2520-2522
Author(s):  
Tamotsu Tojimbara ◽  
Jun Yashima ◽  
Hiroyuki Shirai ◽  
Noriyuki Masaki ◽  
Makoto Tonsho ◽  
...  
Keyword(s):  
Low Dose ◽  
Donation After Circulatory Death ◽  
In Situ Perfusion ◽  
Circulatory Death

Donation after circulatory death: possible strategies for in-situ organ preservation

2020 ◽  
Vol 86 (9) ◽  
Author(s):  
Marinella Zanierato ◽  
Daniele Dondossola ◽  
Alessandro Palleschi ◽  
Alberto Zanella
Keyword(s):  
Organ Preservation ◽  
Donation After Circulatory Death ◽  
Circulatory Death

In situ lung perfusion is a valuable tool to assess lungs from donation after circulatory death donors category I-II

2013 ◽  
Vol 26 (5) ◽  
pp. 485-492 ◽  
Author(s):  
Caroline Van De Wauwer ◽  
Anita J. Munneke ◽  
Gerwin E. Engels ◽  
Foke M. Berga ◽  
Gerhard Rakhorst ◽  
...  
Keyword(s):  
Lung Perfusion ◽  
Donation After Circulatory Death ◽  
Circulatory Death

Differential effects of oligomycin on carotid chemoreceptor responses to O2 and CO2 in the cat

1987 ◽  
Vol 63 (5) ◽  
pp. 2084-2092 ◽  
Author(s):  
M. Shirahata ◽  
S. Andronikou ◽  
S. Lahiri
Keyword(s):  
Carotid Body ◽  
Low Dose ◽  
Perfusion Technique ◽  
Co2 Response ◽  
Ethanol Mixture ◽  
In Situ Perfusion ◽  
Before And After ◽  
New Evidence ◽  
Blank Solution

Effects of oligomycin on carotid chemoreceptor responses to O2 and CO2 were investigated using an in situ perfusion technique. Cats were anesthetized, paralyzed, and artificially ventilated. To avoid a possible reaction between an oligomycin-ethanol mixture and blood, we administered oligomycin to the carotid body via cell- and protein-free perfusate. Except for the perfusion periods, the carotid body received its own natural blood supply. Responses to O2, CO2, sodium cyanide, and nicotine of the same carotid chemoreceptor afferents were studied before and after each perfusion. An appropriate low dose of oligomycin completely blocked carotid chemoreceptor response to O2 while preserving the CO2 response. At the same time cyanide response was attenuated leaving nicotine response intact. Additional doses of oligomycin attenuated carotid chemoreceptor response to CO2 as well. Perfusion with a blank solution containing ethanol did not change the carotid body chemoreceptor responses. These effects of oligomycin on carotid chemoreceptor responses to O2 and CO2 were reversible, and restoration of the response to CO2 preceded that to O2. In addition, oligomycin administered into the blood with close intra-arterial injection produced similar differential blockade of O2 and CO2 chemoreception, preserving the nicotine and dopamine effects. This study confirmed the previous findings and provided new evidence showing that 1) the responses of carotid chemoreceptor to O2 and CO2 were separable by oligomycin due to the inhibition of oxidative phosphorylation and 2) the responses to nicotine and dopamine were intact even after blockade of O2 response.

Evaluation of uncontrolled donation after circulatory death lungs by conventional in-situ effluent gas analysis and ex vivo lung perfusion

2021 ◽  
Author(s):  
Shin Tanaka ◽  
Lucas Hoyos Mejía ◽  
Alejandra Romero Román ◽  
Jose Luis Campo-Cañaveral de la Cruz ◽  
Silvana Crowley Carrasco ◽  
...  
Keyword(s):  
Ex Vivo ◽  
Lung Perfusion ◽  
Gas Analysis ◽  
Donation After Circulatory Death ◽  
Ex Vivo Lung Perfusion ◽  
Circulatory Death

scholarly journals Comparison of Experimental Rat Models in Donation After Circulatory Death (DCD): in-situ vs. ex-situ Ischemia

2021 ◽  
Vol 7 ◽  
Author(s):  
Maria Arnold ◽  
Natalia Méndez-Carmona ◽  
Rahel K. Wyss ◽  
Anna Joachimbauer ◽  
Daniela Casoni ◽  
...  
Keyword(s):  
Circulatory Arrest ◽  
Ex Situ ◽  
Donation After Circulatory Death ◽  
Cardiac Recovery ◽  
Male Wistar Rats ◽  
Developed Pressure ◽  
Graft Storage ◽  
Contractile Recovery ◽  
Circulatory Death

Introduction: Donation after circulatory death (DCD) could substantially improve donor heart availability. However, warm ischemia prior to procurement is of particular concern for cardiac graft quality. We describe a rat model of DCD with in-situ ischemia in order to characterize the physiologic changes during the withdrawal period before graft procurement, to determine effects of cardioplegic graft storage, and to evaluate the post-ischemic cardiac recovery in comparison with an established ex-situ ischemia model.Methods: Following general anesthesia in male, Wistar rats (404 ± 24 g, n = 25), withdrawal of life-sustaining therapy was simulated by diaphragm transection. Hearts underwent no ischemia or 27 min in-situ ischemia and were explanted. Ex situ, hearts were subjected to a cardioplegic flush and 15 min cold storage or not, and 60 min reperfusion. Cardiac recovery was determined and compared to published results of an entirely ex-situ ischemia model (n = 18).Results: In donors, hearts were subjected to hypoxia and hemodynamic changes, as well as increased levels of circulating catecholamines and free fatty acids prior to circulatory arrest. Post-ischemic contractile recovery was significantly lower in the in-situ ischemia model compared to the ex-situ model, and the addition of cardioplegic storage improved developed pressure-heart rate product, but not cardiac output.Conclusion: The in-situ model provides insight into conditions to which the heart is exposed before procurement. Compared to an entirely ex-situ ischemia model, hearts of the in-situ model demonstrated a lower post-ischemic functional recovery, potentially due to systemic changes prior to ischemia, which are partially abrogated by cardioplegic graft storage.

Outcome of Percutaneous Nephrostomy in Children With Ureteropelvic Junction Obstruction

2020 ◽  
Vol 20 (2) ◽  
pp. 61-64
Author(s):  
Mohammad Mahfuzur Rahman Chowdhury ◽  
Rifat Zaman ◽  
Md Amanur Rasul ◽  
Akm Shahadat Hossain ◽  
Shafiqul Alam Chowdhury ◽  
...  
Keyword(s):  
Renal Function ◽  
Low Dose ◽  
Ureteropelvic Junction Obstruction ◽  
Percutaneous Nephrostomy ◽  
Ureteropelvic Junction ◽  
College Hospital ◽  
Medical College ◽  
Split Renal Function

Introduction and objectives: Congenital ureteropelvic junction obstruction (UPJO) is the most common cause of hydronephrosis. Management protocols are based on the presence of symptoms and when the patient is asymptomatic the function of the affected kidney determines the line of treatment. Percutaneous nephrostomy (PCN) became a widely accepted procedure in children in the 1990s. The aim of the study was to evaluate the results of performing percutaneous nephrostomy (PCN) in all patients with UPJO and split renal function (SRF) of less than 10% in the affected kidney, because the management of such cases is still under debate. Methods:This prospective clinical trial was carried out at Dhaka Medical College Hospital from January 2014 to December 2016. Eighteen consecutive patients who underwent PCN for the treatment of unilateral UPJO were evaluated prospectively. In these children, ultrasonography was used for puncture and catheter insertion. Local anesthesia with sedation or general anesthesia was used for puncture. Pig tail catheters were employed. The PCN remained in situ for at least 4 weeks, during which patients received low-dose cephalosporin prophylaxis. Repeat renography was done after 4 weeks. When there was no significant improvement in split renal function (10% or greater) and PCN drainage (greater than 200 ml per day) then nephrectomies were performed otherwise pyeloplasties were performed. The patients were followed up after pyeloplasty with renograms at 3 months and 6 months post operatively. Results: All the patients had severe hydronephrosis during diagnosis and 14 patients with unilateral UPJO were improved after PCN drainage and underwent pyeloplasty. The rest four patients that did not show improvement in the SRF and total volume of urine output underwent nephrectomy. In the patients with unilateral UPJO who improved after PCN drainage, the SRF was increased to 26.4% ±8.6% (mean± SD) after four weeks and pyeloplasty was performed. At three and six months follow-up, SRF value was 29.2% ±8.5% and 30.8.2% ±8.8% respectively. Conclusion: Before planning of nephrectomy in poorly functioning kidneys (SRF < 10%) due to congenital UPJO, PCN drainage should be done to asses improvement of renal function. Bangladesh Journal of Urology, Vol. 20, No. 2, July 2017 p.61-64

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