Renal histopathology features according to various warm ischemiatimes in porcine laparoscopic and open surgery model

Authors

  • Robert Sabbagh Department of Urology, Sherbrooke University, Sherbrooke, QC
  • Arun Chawla Department of Urology, McMaster University, St. Joseph’s Hospital, Hamilton, ON
  • Britton Tisdale Department of Urology, McMaster University, St. Joseph’s Hospital, Hamilton, ON
  • Kevin Kwan Department of Urology, McMaster University, St. Joseph’s Hospital, Hamilton, ON
  • Suman Chatterjee Department of Urology, McMaster University, St. Joseph’s Hospital, Hamilton, ON
  • Jacek M. Kwiecien Central Animal Facility, Department of Veterinary Research Pathology, McMaster University, Hamilton, ON
  • Anil Kapoor Department of Urology, McMaster University, St. Joseph’s Hospital, Hamilton, ON

DOI:

https://doi.org/10.5489/cuaj.558

Abstract

Background: Thirty minutes has been considered as the threshold
for tolerable warm ischemic time (WIT). Recent reports demonstrate
recovery of renal function after longer WIT. We assessed renal
histology according to different WIT in a 2-kidney porcine model.

Methods: Twelve female pigs were randomized to an open or
laparoscopic group. Each pig was further randomized within each
group to clamping the left renal artery for 5, 15, 30, 45, 60 or
180 minutes. Preclamping left renal biopsies were performed on
each pig. The contralateral kidney in each animal was used as an
individual control. On postoperative day 14, all animals underwent
bilateral nephrectomies. Preclamping left renal biopsies
and all renal specimens were evaluated by a blinded veterinary
pathologist.

Results: One pig died in the open group after 180 minutes of
clamping. Histopathology did not show any significant changes
between the two groups and across clamp times from 5 to 60
minutes. After 180 minutes of laparoscopic clamping, there was
evidence of diffuse necrosis.

Interpretation: Sixty minutes of ischemia did not show any permanent
renal damage in both groups. Further studies are needed to
verify these findings in humans. A prolonged ischemic time without
permanent renal damage would be helpful in partial nephrectomy.
Warm ischemic time of 180 minutes exceeded the renal ischemic
burden based on histological features.

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Author Biographies

Robert Sabbagh, Department of Urology, Sherbrooke University, Sherbrooke, QC

Arun Chawla, Department of Urology, McMaster University, St. Joseph’s Hospital, Hamilton, ON

Britton Tisdale, Department of Urology, McMaster University, St. Joseph’s Hospital, Hamilton, ON

Kevin Kwan, Department of Urology, McMaster University, St. Joseph’s Hospital, Hamilton, ON

Suman Chatterjee, Department of Urology, McMaster University, St. Joseph’s Hospital, Hamilton, ON

Jacek M. Kwiecien, Central Animal Facility, Department of Veterinary Research Pathology, McMaster University, Hamilton, ON

Anil Kapoor, Department of Urology, McMaster University, St. Joseph’s Hospital, Hamilton, ON

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How to Cite

Sabbagh, R., Chawla, A., Tisdale, B., Kwan, K., Chatterjee, S., Kwiecien, J. M., & Kapoor, A. (2013). Renal histopathology features according to various warm ischemiatimes in porcine laparoscopic and open surgery model. Canadian Urological Association Journal, 5(1), 40–4. https://doi.org/10.5489/cuaj.558

Issue

Vol. 5 No. 1 (2011): February

Section

Original Research

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