310 EVALUATION OF A NOVEL STRATEGY TO EXTEND WARM ISCHEMIA TIME IN COMPLEX PARTIAL NEPHRECTOMIES (2012)

You have accessJournal of UrologyKidney Cancer: Basic Research II1 Apr 2012310 EVALUATION OF A NOVEL STRATEGY TO EXTEND WARM ISCHEMIA TIME IN COMPLEX PARTIAL NEPHRECTOMIES Jacob Cohen, Thambi Dorai, Andrew Fishman, and Michael Grasso Jacob CohenJacob Cohen New York City, NY , Thambi DoraiThambi Dorai Valhalla, NY , Andrew FishmanAndrew Fishman Valhalla, NY , and Michael GrassoMichael Grasso Valhalla, NY View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.369AboutPDF Cite Export CitationSelect Citation formatNLMAMAIEEEACMAPAChicagoMLAHarvardTips on citation downloadDownload citationCopy citation ToolsAdd to favoritesTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ischemia/reperfusion injury (IRI) is an important cause of acute renal failure following partial nephrectomy procedures that necessitate renal artery occlusion for more than 30 minutes. We have been working on strategies aimed at extending warm ischemia time (WIT) while at the same time preserving parenchymal renal function. METHODS A Sprague-Dawley rat renal ischemia model was developed, clamping the left renal hilum for 40, 50, 60 and 70 minutes, followed by 48 hours of reperfusion. An improved renoprotective cocktail [called GPMI consisting of growth factors such as basic fibroblast growth factor (bFGF), erythropoietin (EPO), stromal-cell derived factor-1 (SDF-1), bone morphogenic protein-7 (BMP-7) and vascular endothelial cell derived growth factor (VEGF) ( G); a mitochondria targeting porphyrin (MnTnHex-2-PyP5+) (P), mitochondria protecting amino acids such as á-ketoglutarate and L-Aspartic acid (M) supplemented with (I) which is a mixture of L-Glutamine, Cardiolipin, Reduced Glutathione, N-Acetylcysteine, á-Lipoic acid, O-Acetyl Carnitine, Resveratrol, Succinic acid, Taurine, Coenzyme Q10 and L-Ascorbic acid] was given through intraperitoneal and subcutaneous routes at −48, −24, 0 and 24 hours after surgery. At 48 hours post-surgery, the two kidneys were harvested and examined with hematoxylin-eosin (H&E) and periodic acid Schiff stains for renal injury induced necrosis. In addition, the renal ischemia markers such as lipocalin-2 and galectin-3 were followed using immunoblots. RESULTS Compared to ischemia-only controls, kidneys treated with GPMI showed significant reversal of pathological changes associated with necrosis for 40 as well as 50 minute clamping periods. At 60 and 70 minute WIT, the necrotic changes were extensive and could not be reversed with GPMI. CONCLUSIONS This method builds upon our earlier work and suggests an unique opportunity to extend WIT up to 50 minutes. Further work is needed to refine the renoprotective effects of GPMI in a clinical setting and extend WIT beyond 60 minutes. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e125-e126 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Metrics Author Information Jacob Cohen New York City, NY More articles by this author Thambi Dorai Valhalla, NY More articles by this author Andrew Fishman Valhalla, NY More articles by this author Michael Grasso Valhalla, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...