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An Experimental and Clinical Evaluation

Paul J. Garvin, MD; James D. Buttorff, MD; Robert Morgan, RN; John E. Codd, MD

Arch Surg. 1980;115(2):180-182.

Abstract
• Cadaver kidneys from donors who have sustained cardiac standstill are often unsuitable for transplantation due to prolonged warm ischemic time. In an attempt to increase the salvage rate of these kidneys, the efficacy of in situ intra-aortic cold perfusion in producing immediate function of allografted kidneys was assessed in the nonheart beating canine model. In the first experiment, kidneys harvested after cardiac standstill and immediate intra-aortic cold perfusion were demonstrated to function equally as well as kidneys harvested "optimally." In the second experiment, evaluation of intra-aortic cold perfusion on renal core temperature demonstrated rapid cooling of these kidneys to a protective range. Early clinical results in donors whose kidneys were removed after cardiac arrest demonstrate that most of the kidneys allotransplanted after in situ intra-aortic cold perfusion functioned immediately. These preliminary experimental and clinical results demonstrate the effectiveness of in situ intra-aortic cold perfusion. Wider application of this technique to donors with cardiac standstill should increase the available organs for transplantation.

(Arch Surg 115:180-182, 1980)

Author Affiliations
From the Department of Surgery, St Louis University and John Cochran Veterans Administration Hospital, St Louis.

Footnotes
Accepted for publication July 18, 1979.

Reprint requests to Department of Surgery, St Louis University School of Medicine, 1325 S Grand Blvd, St Louis, MO 63104 (Dr Garvin).

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