Deep neuromuscular blockade improves surgical conditions during low-pressure pneumoperitoneum laparoscopic donor nephrectomy

Transplant surger

Does deep neuromuscular block affect pain after laparoscopic surgery?

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Comment on Rosenberg J, et al.: "Deep Neuromuscular Blockade Improves Laparoscopic Surgical Conditions: A Randomized, Controlled Study"

Perioperative Medicine: Efficacy, Safety and Outcom

Is the Reluctance for the Implantation of Right Kidneys Justified: Reply

Contains fulltext : 175622.pdf (publisher's version ) (Open Access

The need to reduce cold ischemia time in kidney transplantation

Item does not contain fulltextPURPOSE OF REVIEW: Hypothermic preservation is a prerequisite for kidney exchange in transplantation. The severity of tissue damage caused by hypothermic preservation influences the level of ischemia/reperfusion injury and subsequent graft function. With the purpose of reviewing the implications of prolonged cold ischemia time (CIT) in kidney transplantation, its pathophysiology, effects on early and late outcome of transplantation for different types of deceased organ donors, and preservation methods are discussed based on recent literature. RECENT FINDINGS: The main findings are that the consequences of a prolonged CIT are mainly identifiable in the early posttransplant period as delayed graft function, especially in expanded criteria donors, and possibly in an increased acute rejection rate. The preferred method of hypothermic preservation in expanded criteria donors and donors after cardiac death appears to be machine preservation. SUMMARY: The effects of CIT on the long-term outcome of renal transplantation in the form of impaired graft function and graft survival are less evident

Response to "Re: Remote Ischemic Preconditioning to Reduce Contrast-induced Nephropathy: A Randomized Controlled Trial"

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Outcome of Kidney Allografts in Recipients With a Femoral Arteriovenous Fistula: Report of Two Cases

Contains fulltext : 171106.pdf (publisher's version ) (Open Access)Two patients, who were on hemodialysis over a femoral arteriovenous fistula, were transplanted in our center. Despite adequate blood pressure, perfusion of the renal allograft remained poor after completion of the vascular anastomoses. Ligation of the femoral arteriovenous fistula (1.6 L/min) led to adequate perfusion. Initial graft function was good. Although it remains unclear whether ischemia of a renal allograft is caused by venous hypertension or vascular steal due to a femoral arteriovenous fistula, it might be necessary to ligate a femoral arteriovenous fistula to obtain adequate graft perfusion

Letter to the editor: considering the effects of deep neuromuscular blockade on endoscopic surgical conditions during transurethral resection of a bladder tumor (TURB)

Perioperative Medicine: Efficacy, Safety and Outcom

Saccular Abdominal Aortic Aneurysms: Patient Characteristics, Clinical Presentation, Treatment, and Outcomes in the Netherlands.

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Renal Perfusion and Function during Pneumoperitoneum: A Systematic Review and Meta-Analysis of Animal Studies

Both preclinical and clinical studies indicate that raised intra-abdominal pressure (IAP) associated with pneumoperitoneum during laparoscopic surgical procedures can cause renal damage, the severity of which may be influenced by variables such as pressure level and duration. Several of these variables have been investigated in animal studies, but synthesis of all preclinical data has not been performed. This systematic review summarizes all available pre-clinical evidence on this topic, including an assessment of its quality and risk of bias. We performed meta-analysis to assess which aspects of the pneumoperitoneum determine the severity of its adverse effects. A systematic search in two databases identified 55 studies on the effect of pneumoperitoneum on renal function which met our inclusion criteria. There was high heterogeneity between the studies regarding study design, species, sex, pressure and duration of pneumoperitoneum, and type of gas used. Measures to reduce bias were poorly reported, leading to an unclear risk of bias in the majority of studies. Details on randomisation, blinding and a sample size calculation were not reported in >/=80% of the studies. Meta-analysis showed an overall increase in serum creatinine during pneumoperitoneum, and a decrease in urine output and renal blood flow. Subgroup analysis indicated that for serum creatinine, this effect differed between species. Subgroup analysis of pressure level indicated that urine output decreased as IAP level increased. No differences between types of gas were observed. Data were insufficient to reliably assess whether sex or IAP duration modulate the effect of pneumoperitoneum. Four studies assessing long-term effects indicated that serum creatinine normalized >/=24 hours after desufflation of pneumoperitoneum at 15mmHg. We conclude that harmful effects on renal function and perfusion during pneumoperitoneum appear to be robust, but evidence on long-term effects is very limited. The reliability and clinical relevance of these findings for healthy patients and patients at high risk of renal impairment remain uncertain. We emphasize the need for rigorous reporting of preclinical research methodology, which is of vital importance for clinical translation of preclinical data