Retro-peritoneal cooling for kidney preservation from multi-organ cadaver donors

Abstract

Background: Minimizing ischemia is paramount in the procurement of kidneys for transplantation. A fast cooling and expeditious removal is ideal to minimize damage from warm ischemia, however, since the removal of kidneys is delayed in cadaver donation until all other organs are harvested, the risk of kidney damage increases due to contact with the warmer soft body tissues. Surgical techniques that expedite organ retrieval were developed to avoid organ damage.

Methods: We test a modification of Thomas Starzl's improved technique for multi-organ harvesting by interposing an ice bag between the posterior aspect of the kidney and the psoas muscle in a randomized trial with 21 multi-organ cadaver donors.

Results: The modified technique decreases the extraction temperature of the kidneys significantly in comparison with the controls, p < .001.

Conclusions: This simple technique improves the preservation of kidneys from cadaver donors, and can potentially have more impact on multi-organ donation after cardiac death.

Keywords: Cadaver donation; Cold ischemia; Kidney preservation; Surgical technique; Transplants.