Extracorporeal Renal Parenchymal Surgery With Continuous Perfusion

MORE than ten years ago, in The Journal, Hardy¹ reported the first successful renal autotransplantation in man. The indication for the operation was iatrogenic ureteral trauma. Subsequent reports have established the usefulness of this procedure in the treatment of other ureteral^2-4 and renovascular⁴ lesions. A natural outgrowth of this procedure was the use of initial arterial washout and subsequent surface cooling⁵ for vascular lesions requiring time-consuming reconstruction prior to reimplantation.

Since continuous pulsatile perfusion with chilled, oxygenated, cryoprecipitated plasma has proved to be a more satisfactory means of renal preservation than surface cooling,⁶ its use should afford greater protection to kidneys subjected to prolonged extracorporeal operative periods. Corman et al⁷ first reported the use of extracorporeal renal parenchymal surgery with continuous pulsatile perfusion, which they unsuccessfully employed for bilateral renal carcinoma. The following is a case of successful extracorporeal renal perfusion and parenchymal surgery.

Report of a Case