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Biomedical subjects

R Grundmann

Publications and source records attributed to R Grundmann.

At least 109 records · Page 6Linked to original sources
PubMed1979

[Kidney preservation by mechanical perfusion or hypothermic storage].

The efficiency of hypothermic mechanical perfusion and hypothermic storage, resp., for kidney preservation was to be examined. For this purpose dog kidneys were subdued to 0 to 60 min of warm ischemia, then preserved for 12--72 hours and thereafter transplanted. It could be concluded: 1. Hypothermic mechanical perfusion makes a successful 72 hour preservation possible with excellent kidney function immediately after transplantation. After 30 minutes of warm ischemia the preservation period should be limited to 24 hours. 2. Hypothermic storage is inferior to mechanical perfusion concerning the immediate function after transplantation: 24 hours storage time and 15 minutes of warm ischemia should not be exceeded. 3. Kidney function decreases exponentially by the time of preservation. This means that the warm ischemic period and the preservation time, resp., should be as short as possible to get an undamaged kidney after transplantation: the shorter the preservation period the better the kidney function after transplantation.

Animals↗
PubMed1979

[Canine kidney preservation by intermittent perfusion with hypothermic Collins- or Sacks-solution (author's transl)].

37 canine kidneys were intermittently perfused with Collins- or Sacks-solution every 2--6 h. 32 of these kidneys were transplanted after 12--24 h storage time. Additionally, 24 kidneys were stored under hypothermia for 12--24 h and then transplanted (control group). During perfusion the oxygen consumption of the kidneys and the enzyme and lactate release were measured. It was impossible to improve the results of hypothermic storage preservation by intermittent perfusion of the kidneys, on the contrary kidney function deteriorated by the number of perfusion processes. The failure of intermittent perfusion is caused by the increase of renal vascular resistance during perfusion. From the oxygen consumption and lactate release measurement it was concluded, that the washout solutions for kidney preservation should contain more substrate which can be utilized under anaerobic conditions to improve the results of hypothermic storage preservation.

Animals↗
PubMed1978

[Kidney preservation by hypothermic storage in Collins and Sacks solutions: the influence of 0-30 min of warm ischemia on the available preservation period (author's transl)].

123 kidneys of mongrel dogs were stored under hypothermic conditions in Collins or Sacks solutions for 12 up to 72 h and then transplanted. Before preservation the kidneys were subdued to 0-30 min warm ischemia. Kidney function after transplantation was measured by PAH-and inulin-clearances. Successful 24 h preservation was likewise possible with Collins and Sacks solutions if there was not any warm ischemia. Kidney function was reduced by the length of preservation, according to the formula; y = 166.02 . e-0,125x (y = PAH-clearance and x = preservation time). With both solutions the most attainable preservation time after 15 min warm ischemia was only 12 h, longer preservation time or ischemic periods were not tolerable. However, the function of the ischemically damaged organ was significantly better preserved by Sacks solution in comparison with Collins solution-although the preservation period could not be extended by this solution. Therefore, as far as human kidney preservation is concerned, Collins solution should be replaced by Sacks solution.

Animals↗
PubMed1978

[Preservation of kidneys with ischemic injury using hypothermic storage and mechanical prolonged perfusion].

Dog kidneys were flushed and stored in Collins (n = 30) and Sacks (n = 32) solution under hypothermia. These results were compared with those gained by mechanical perfusion (n = 21). Before preservation, the kidneys were subjected to 15 - 60 min of warm ischemia then stored for 12 - 24 h. It was concluded that 12-h preservation time after 15-min ischemic injury was the limit of hypothermic storage preservation. Sacks' solution gave better results than Collins' solution as regards the immediate function after transplantation. In contrast, mechanical perfusion was well tolerated for 24-h preservation time after a warm ischemia of 30 min. In case of warm ischemic damage, mechanical perfusion should be preferred to hypothermic storage.

Animals↗
PubMed1978

[Metabolic status of hypothermically stored dog kidneys with various perfusion solutions and ischemia pretreatment].

In experiments on canine kidneys, cortical edema formation during hypothermic storage following a period of normothermic ischemia of up to 30 min duration was - according to the osmolality of the perfusion fluid - lower after flush perfusion with Sacks II solution than with Biotest-"Collins" solution or Ringer-mannitol solution, which resulted in the highest edema. The adenine nucleotide content fell corresponding to the duration of the hypothermic storage or the duration of an initial normothermic ischemia, but only small further changes were found during storage following initial normothermic damage. Moreover, with respect to the maintenance of nucleotide contents the strong hyperosmolar intracellular solutions were not superior to Ringer-mannitol solution of 330 mosmol/liter.

Adenine Nucleotides↗
PubMed1977

The immediate function of the kidney after 24-to 72-hr preservation. Hypothermic storage versus mechanical perfusion.

Seventy-two dog kidneys were stored under hypothermia as described by Collins and Sacks between 24 and 72 hr and then transplanted. The immediate function of the kidneys was measured by p-aminohippuric acid and inulin clearances. Twenty-four hr proved to be the maximum safe preservation time with both methods. The immediate function of the kidneys stored under hypothermia could not be improved by the addition of furosemide to the flushing solution. These results were compared with those gained by mechanical perfusion of the organ. Kidney function after 72 hr of hypothermic mechanical perfusion was significantly better than after 24 hr of hypothermic storage.

Animals↗
PubMed1977

Relationship between the prolongation of warm ischemia and the maximum available preservation period.

Fifty dog kidneys had hypothermic perfusion for 12 to 72 hours and then were transplanted. Prior to perfusion the kidneys were subjected to 15, 30, 45, and 60 minutes of warm ischemia. Fifteen minutes of warm ischemia was well tolerated (successful 72 hour preservation), but after 30 minutes successful preservation could be achieved for 24 hours only. Enzyme release and lactate formation were related to the prolongation of warm ischemia, and the highly significant concentration differences of these substances, between well functioning kidneys and those with small or no function, indicated the viability of the organ.

Animals↗
PubMed1977

[Possibilities of controlling blood less in liver resection].

The methods are described by which blood loss can be reduced during hepatic surgery. This requires the proper surgical techniques (control method of hepatic lobectomy and occasionally the atypical resection with the use of a clamp- "crush" method). In additions clamping of the liver hilus and resection under hypothermia, the resection of the isolated bloodless organ under hypothermia, the application of an internal caval shunt, intraoperative autotransfusion, and acute preoperative hemodilution should be performed. The internal caval shunt can be successfully used in the case of emergency as well as during excision of large tumors which have involved the liver tissue adjacent to the vena cava. In these cases the method of complete vascular isolation and hypothermic perfusion should be performed additionally. Acute preoperative hemodilution should be widely applied with hepatic surgery; blood clotting is not impaired by this method.

Blood Transfusion, Autologous↗
PubMed1977

[Kidney preservation by mechanical perfusion and by hypothermic storage: a comparative study].

72 dog kidneys were stored under hypothermia as described by COLLINS and SACKS between 24 and 72 hrs and then transplanted. The immediate function of the kidneys was measured by PAH and inulin clearances. 24 hrs proved to be the maximum safe preservation time with both methods. The immediate function of the kidneys stored under hypothermia could not be improved by the addition of furosemide to the flushing solution. These results were compared with those gained by mechanical perfusion of the organ: kidney function after 72 hrs of hypothermic mechanical perfusion was significantly better than after 24 hrs of hypothermic storage.

Animals↗
PubMed1976

[The influence of warm ischaemic time on the results of hypothermic kidney perfusion (author's transl)].

50 dog kidneys were mechanically perfused under hypothermia for between 12 and 72 h and then transplanted. Before perfusion the kidneys were subjected to 15,30,45 and 60 min of warm ischaemia: 15 min of warm ischaemia were well tolerated (successful 72-h preservation), but after 30 min preservation was successful for only 24 h. Enzyme release and lactate formation depended on the duration of warm ischaemia. Furthermore, these perfusate concentrations indicated the viability of the organ (highly significant differences between well functioning kidneys and those with little or no function.

Animals↗
PubMed1975

[Technique and results of hepatic resection (author's transl)].

12 major hepatic resections are described. There were two postoperative deaths. 4 patients received more than two blood units intra- or immediately postoperatively (maximal blood loss 5000 and 4400 ml resp.). In 5 patients the operative procedure was performed in hemodilution, in these patients the maximal transfusion rate ranged to one blood unit. In nearly all patients a subphrenic collection of bile, blood and secretion was observed, but this was well treated conservatively. The various operative procedures, the possibility to avoid blood loss during hepatic resection and the concept of biliary drainage are discussed.

Bile Duct Neoplasms↗
PubMed1975

[A new organ perfusion system: Successful preservation of kidney function for 72 hrs (author's transl)].

A new preservation system is described. In this unit 17 dog kidneys were nonpulsatile perfused with hypothermic human albumin for 72 hrs and then transplanted. All kidneys started immediately to function and the PAH and inulin clearances attained normal values at least at the 7th postoperative day. The quality of the immediate function is referred to the applied perfusion pressure (20 mm Hg) and the applied temperature of the perfusion medium (7.5 degrees C). During preservation substrate utilization (oxygen, unesterified fatty acids) and the accumulation of toxic metabolic products (ammonia, uric acid) were controlled in the perfusate. Their importance concerning to the limitation of preservation time is discussed.

Albumins↗
PubMed1975

Analysis of the optimal perfusion pressure and flow rate of the renal vascular resistance and oxygen consumption in the hypothermic perfused kidney.

Thirty-six dog kidneys were perfused with different perfusion pressures (between 15 and 60 mm. Hg) for 72 hours and then transplanted. Hypothermic human albumin was the perfusion fluid. Enzyme release, kidney weight, and renal oxygen consumption were measured during perfusion. Kidneys perfused with a flow rate of 0.8 ml. per gram per minute (21 mm. Hg mean perfusion pressure) showed the smallest increase in kidney weight and the best function after transplantation. Renal vascular resistance was independent of the level of the perfusion pressure and renal oxygen consumption was independent of the applied flow rate. It is concluded that the perfusion pressure applied with hypothermic perfusion should be as low as possible because in this way kidney damage caused by perfusion can be avoided most easily.

Animals↗
PubMed1975

[Optimum perfusion pressure, renal resistance and oxygen consumption of kidney in hypothermic pulsating perfusion].

36 dog kidneys were perfused with different perfusion pressures (between 15 and 60 mm Hg) for 72 hrs and then transplanted. Hypothermic human albumin was the perfusion fluid. Kidneys perfused with a flow rate of 0.8 ml/g/min (21 mm Hg mean perfusion pressure) showed the smallest increase in kidney weight and the best function after transplantation. Renal vascular resistance was independent of the level of the perfusion pressure and renal oxygen consumption was independent of the applied flow rate.

Animals↗