Significance of Cold Renal Perfusion on Renal Function and Clinical Outcomes When Renal Ischemia Time Exceeded 30 Min during Pararenal and Juxtarenal Abdominal Aortic Aneurysm Surgery
Objectives: To investigate the influence of cold renal
perfusion on renal function and clinical outcomes in cases where the renal
ischemia time exceeded 30 min during pararenal and juxtarenal abdominal
aortic aneurysm (P/JAAA) surgery. Methods and Results: Fifty-four
patients who underwent open repair for P/JAAAs were retrospectively analyzed.
Thirty-nine patients received renal perfusion
with cold Ringer’s solution (perfusion group) and 15 patients did not receive
renal perfusion (non-perfusion group). There were no significant differences in
preoperative serum creatinine level (Cr) (1.08 ± 0.42 vs. 1.35 ± 0.71
mg/dL, p = 0.09), percentage of patients with Cr > 2 mg/dL [2/38 (5%) vs.
2/15 (13%), p = 0.8], and renal ischemia time during proximal aortic clamping
(49 ± 21 vs. 47 ± 11 min; p = 0.8) between the groups. Postoperative Cr was
significantly lower in the perfusion group than in the non-perfusion group
(1.48 ± 0.76 vs. 2.23 ± 1.21 mg/dL, p < 0.01). The percentage of patients with
postoperative Cr > 2 mg/dL was also
significantly lower in the perfusion group than in the non-perfusion group [5
(13%) vs. 7 (47%), p < 0.01)]. At discharge, Cr returned to
preoperative levels in both groups. All patients were discharged from the
hospital without incidents. Conclusion: Renal artery perfusion with cold
Ringer’s solution clearly reduced the deterioration
of postoperative renal function compared to non-renal perfusion.
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