PD41-10 COMPARISON OF WARM AND COLD ISCHEMIA ON RENAL FUNCTION AFTER PARTIAL NEPHRECTOMY

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV1 Apr 2016PD41-10 COMPARISON OF WARM AND COLD ISCHEMIA ON RENAL FUNCTION AFTER PARTIAL NEPHRECTOMY Yushi Yamauchi, Yasuhito Funahashi, Naoto Sassa, Yasushi Yoshino, Tokunori Yamamoto, and Momokazu Gotoh Yushi YamauchiYushi Yamauchi More articles by this author , Yasuhito FunahashiYasuhito Funahashi More articles by this author , Naoto SassaNaoto Sassa More articles by this author , Yasushi YoshinoYasushi Yoshino More articles by this author , Tokunori YamamotoTokunori Yamamoto More articles by this author , and Momokazu GotohMomokazu Gotoh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1556AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To assess renal functional deterioration after partial nephrectomy with warm and cold ischemia using 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) renal scintigraphy parameters. METHODS Open partial nephrectomy was performed in 59 patients with warm ischemia and 64 patients with cold ischemia. 99mTc-MAG3 renal scintigraphy was performed and effective renal plasma flow was calculated to evaluate split renal function. In addition, regional 99mTc-MAG3 uptake was analyzed in the surgically unaffected parts to evaluate ischemic damage. RESULTS The mean tumor size in the warm and cold ischemia groups was 2.9 and 3.2 cm, respectively, and the mean ischemic time was 24.2 minutes (range, 8-46 minutes) and 26.7 minutes (range, 8-58 minutes), respectively. One week after surgery, effective renal plasma flow in the operated kidney decreased to 66.2% (from 160.2 to 105.4 mL/min/1.73 m2) in the warm ischemia group and to 77.4% (from 152.3 to 116.6 mL/min/1.73 m2) in the cold ischemia group. Reginal 99mTc-MAG3 uptake changed to 89.2% of baseline in the warm ischemia group and 101.5% of baseline in the cold ischemia group. When the ischemic time was 25 minutes, regional 99mTc-MAG3 uptake in the warm ischemia group did not recover to the baseline level at 6 months. Multiple regression analyses demonstrated a significant correlation between ischemic time and the decrease in regional 99mTc-MAG3 uptake in the warm ischemia group, but not in the cold ischemia group. CONCLUSIONS Warm ischemia for 25 minutes caused long lasting diffuse damage throughout the operated kidney, whereas cold ischemia for up to 58 minutes prevented ischemic injury to the renal remnant. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e943-e944 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Yushi Yamauchi More articles by this author Yasuhito Funahashi More articles by this author Naoto Sassa More articles by this author Yasushi Yoshino More articles by this author Tokunori Yamamoto More articles by this author Momokazu Gotoh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...