Comparison of Clamping Modalities in a Rabbit Model of Normothermic Renal Ischemia

Abstract

Purpose: The objective of this study was to investigate the patterns of renal function recovery with different renal vessel clamping modalities during a prolonged warm ischemia (WI) condition in an experimental two-kidney rabbit model. Materials and Methods: Twenty-eight rabbits were randomly clustered into four groups and underwent laparotomy with different types of renal pedicle clamping. Group 1 (n = 4) was sham-operated. Group 2 (n = 8) underwent 80 minutes of WI with artery only clamping. Group 3 (n = 8) underwent arteriovenous clamping for 80 minutes, and group 4 (n = 8) received an arteriovenous clamping for 80 minutes with 10-second declamping periods every 20 minutes. Serum levels of creatinine (SCr) were recorded preoperatively and on postoperative days (PODs) 1, 3, and 7. Renal function was evaluated by (99m)technetium-mercaptoacetyltriglycine scintigraphy. Afterward, the animals were euthanized, and the kidneys were harvested and evaluated microscopically. Results: Renal function completely recuperated on POD 7 in the groups that underwent artery only and ateriovenous intermittent clamping, and both of these methods were superior to ateriovenous clamping (P < 0.001). SCr showed a similar variation in all the clamping groups and did not demonstrate statistical differences among the groups. Histopathologic changes were similar among the ischemic groups. Conclusion: The less deleterious clamping modalities in this experimental model were the artery only and intermittent en bloc clamping methods.