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Masao Tanaka - One of the best experts on this subject based on the ideXlab platform.
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effect of synthetic protease inhibitor gabexate mesilate on the attenuation of ischemia reperfusion injury in canine Kidney Autotransplantation
Surgery, 2005Co-Authors: Shigetaka Inoue, Atsushi Sugitani, Hirofumi Yamamoto, Hidehisa Kitada, Kentaro Motoyama, Yasuhiro Okabe, Morihito Ohta, Junichi Yoshida, Kenichi Nishiyama, Masao TanakaAbstract:Background Kidneys from non–heart-beating donors are associated with delayed graft function and a high rejection rate due to the long period of warm ischemia. Gabexate mesilate (GM), a synthetic serine protease inhibitor, has been shown to improve organ function by suppressing cytokine activity and neutrophil function after ischemia/reperfusion. In this study, we evaluated the effect of GM on renal function after warm ischemia in a canine Kidney Autotransplantation model. Methods After 60 minutes of warm ischemia, the left Kidney was transplanted into the iliac fossa, and the right Kidney was removed. The control group (n = 7) and GM group (n = 7) were evaluated for serum creatinine and blood urea nitrogen (BUN) concentrations, renal tissue blood flow, resistive index, pulsatility index, interleukin (IL)-1β and tumor necrosis factor (TNF)-α mRNA expression levels in peripheral blood mononuclear cells, apoptotic index, CD10 immunolabeling as an indicator of brush border injury, and standard histopathology. Results Compared with controls, administration of GM resulted in lower serum creatinine concentrations (11.3 ± 2.4 vs 5.2 ± 3.3 mg/dL at 72 hours; P = .04) and BUN concentrations (188 ± 26 mg/dL vs 98 ± 41 mg/dL at 72 hours; P = .04), as well as better tissue blood flow, improvement of brush border injury and apoptotic index (each P Conclusions The present study shows that GM protected renal function after warm ischemia/reperfusion by inhibition of serine proteases, maintenance of tissue blood flow, and amelioration of tubular apoptosis.
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Effect of synthetic protease inhibitor gabexate mesilate on the attenuation of ischemia/reperfusion injury in canine Kidney Autotransplantation.
Surgery, 2005Co-Authors: Shigetaka Inoue, Atsushi Sugitani, Hirofumi Yamamoto, Hidehisa Kitada, Kentaro Motoyama, Yasuhiro Okabe, Morihito Ohta, Junichi Yoshida, Kenichi Nishiyama, Masao TanakaAbstract:Background Kidneys from non–heart-beating donors are associated with delayed graft function and a high rejection rate due to the long period of warm ischemia. Gabexate mesilate (GM), a synthetic serine protease inhibitor, has been shown to improve organ function by suppressing cytokine activity and neutrophil function after ischemia/reperfusion. In this study, we evaluated the effect of GM on renal function after warm ischemia in a canine Kidney Autotransplantation model. Methods After 60 minutes of warm ischemia, the left Kidney was transplanted into the iliac fossa, and the right Kidney was removed. The control group (n = 7) and GM group (n = 7) were evaluated for serum creatinine and blood urea nitrogen (BUN) concentrations, renal tissue blood flow, resistive index, pulsatility index, interleukin (IL)-1β and tumor necrosis factor (TNF)-α mRNA expression levels in peripheral blood mononuclear cells, apoptotic index, CD10 immunolabeling as an indicator of brush border injury, and standard histopathology. Results Compared with controls, administration of GM resulted in lower serum creatinine concentrations (11.3 ± 2.4 vs 5.2 ± 3.3 mg/dL at 72 hours; P = .04) and BUN concentrations (188 ± 26 mg/dL vs 98 ± 41 mg/dL at 72 hours; P = .04), as well as better tissue blood flow, improvement of brush border injury and apoptotic index (each P Conclusions The present study shows that GM protected renal function after warm ischemia/reperfusion by inhibition of serine proteases, maintenance of tissue blood flow, and amelioration of tubular apoptosis.
Shigetaka Inoue - One of the best experts on this subject based on the ideXlab platform.
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effect of synthetic protease inhibitor gabexate mesilate on the attenuation of ischemia reperfusion injury in canine Kidney Autotransplantation
Surgery, 2005Co-Authors: Shigetaka Inoue, Atsushi Sugitani, Hirofumi Yamamoto, Hidehisa Kitada, Kentaro Motoyama, Yasuhiro Okabe, Morihito Ohta, Junichi Yoshida, Kenichi Nishiyama, Masao TanakaAbstract:Background Kidneys from non–heart-beating donors are associated with delayed graft function and a high rejection rate due to the long period of warm ischemia. Gabexate mesilate (GM), a synthetic serine protease inhibitor, has been shown to improve organ function by suppressing cytokine activity and neutrophil function after ischemia/reperfusion. In this study, we evaluated the effect of GM on renal function after warm ischemia in a canine Kidney Autotransplantation model. Methods After 60 minutes of warm ischemia, the left Kidney was transplanted into the iliac fossa, and the right Kidney was removed. The control group (n = 7) and GM group (n = 7) were evaluated for serum creatinine and blood urea nitrogen (BUN) concentrations, renal tissue blood flow, resistive index, pulsatility index, interleukin (IL)-1β and tumor necrosis factor (TNF)-α mRNA expression levels in peripheral blood mononuclear cells, apoptotic index, CD10 immunolabeling as an indicator of brush border injury, and standard histopathology. Results Compared with controls, administration of GM resulted in lower serum creatinine concentrations (11.3 ± 2.4 vs 5.2 ± 3.3 mg/dL at 72 hours; P = .04) and BUN concentrations (188 ± 26 mg/dL vs 98 ± 41 mg/dL at 72 hours; P = .04), as well as better tissue blood flow, improvement of brush border injury and apoptotic index (each P Conclusions The present study shows that GM protected renal function after warm ischemia/reperfusion by inhibition of serine proteases, maintenance of tissue blood flow, and amelioration of tubular apoptosis.
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Effect of synthetic protease inhibitor gabexate mesilate on the attenuation of ischemia/reperfusion injury in canine Kidney Autotransplantation.
Surgery, 2005Co-Authors: Shigetaka Inoue, Atsushi Sugitani, Hirofumi Yamamoto, Hidehisa Kitada, Kentaro Motoyama, Yasuhiro Okabe, Morihito Ohta, Junichi Yoshida, Kenichi Nishiyama, Masao TanakaAbstract:Background Kidneys from non–heart-beating donors are associated with delayed graft function and a high rejection rate due to the long period of warm ischemia. Gabexate mesilate (GM), a synthetic serine protease inhibitor, has been shown to improve organ function by suppressing cytokine activity and neutrophil function after ischemia/reperfusion. In this study, we evaluated the effect of GM on renal function after warm ischemia in a canine Kidney Autotransplantation model. Methods After 60 minutes of warm ischemia, the left Kidney was transplanted into the iliac fossa, and the right Kidney was removed. The control group (n = 7) and GM group (n = 7) were evaluated for serum creatinine and blood urea nitrogen (BUN) concentrations, renal tissue blood flow, resistive index, pulsatility index, interleukin (IL)-1β and tumor necrosis factor (TNF)-α mRNA expression levels in peripheral blood mononuclear cells, apoptotic index, CD10 immunolabeling as an indicator of brush border injury, and standard histopathology. Results Compared with controls, administration of GM resulted in lower serum creatinine concentrations (11.3 ± 2.4 vs 5.2 ± 3.3 mg/dL at 72 hours; P = .04) and BUN concentrations (188 ± 26 mg/dL vs 98 ± 41 mg/dL at 72 hours; P = .04), as well as better tissue blood flow, improvement of brush border injury and apoptotic index (each P Conclusions The present study shows that GM protected renal function after warm ischemia/reperfusion by inhibition of serine proteases, maintenance of tissue blood flow, and amelioration of tubular apoptosis.
Jean-baptiste Ricco - One of the best experts on this subject based on the ideXlab platform.
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Editor's Choice - Ex vivo Renal Artery Repair with Kidney Autotransplantation for Renal Artery Branch Aneurysms: Long-term Results of Sixty-seven Procedures.
European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 2016Co-Authors: Ambroise Duprey, Bertrand Chavent, V. Meyer-bisch, Jean-noël Albertini, Jean-pierre Favre, Xavier Barral, T. Varin, Jean-baptiste RiccoAbstract:Objective/Background To evaluate the long-term outcome of renal revascularization by ex vivo renal artery reconstruction and Autotransplantation for renal artery branch aneurysms (RABAs). Methods Between 1991 and 2015, 67 ex vivo renal artery reconstructions with Kidney Autotransplantation were performed in 55 adults (mean age 47 years) and 10 children to repair 87 RABAs. The main underlying disease was fibromuscular dysplasia in 34 patients. Other etiologies were systemic congenital disease in eight patients, spontaneous dissecting aneurysms in five, iatrogenic aneurysms in three, atheromatous aneurysms in two and unknown etiology in 13. Median RABA diameter was 20.5 mm. Fifty-three patients (82%) were hypertensive, 60 had normal renal function and no patient was on hemodialysis. Seven patients (11%) were operated on after failure of an endovascular procedure. The mean number of renal artery branches repaired per patient was 3.5 and multiple aneurysms were treated in 14 patients (22%). The hypogastric artery was used in 41 patients, the saphenous vein in 18, the superficial femoral artery in five and a combination of different materials in three. Results No deaths occurred during the first 30 days. Primary patency at 30 days was 90.8% following to six early thromboses. Three patients (5%) were lost to follow up. No other thrombosis occurred. At 8 years, the primary and primary-assisted patency were 88% and 91%, respectively. Survival was 95% at 9 years. Among the 53 hypertensive patients, two were lost to follow up. At 9 years, 22 (43%) were cured and nine (18%) were improved with a significant reduction of antihypertensive medication ( p p > .05). Conclusion Ex vivo renal artery reconstruction for complex RABAs eliminates the risk of rupture, confers a benefit to hypertension, and preserves renal function with a satisfactory long-term patency.
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Ex-vivo Renal Artery Reconstruction with Kidney Autotransplantation for Renal Artery Branch Aneurysms: Late Results of 67 Procedures
European Journal of Vascular and Endovascular Surgery, 2015Co-Authors: Bertrand Chavent, Ambroise Duprey, V. Meyer-bisch, Jean-noël Albertini, Jean-pierre Favre, Xavier Barral, Jean-baptiste RiccoAbstract:s 393 of this study is to determine the true incidence and long term outcome of CIN in the optimised CKD population. Methods: Consecutive patients with stage III-V CKD, undergoing peripheral (group 1) or cardiac (group 2) angiography at a single centre regional Australian hospital between 2005 e2015 were included. Patients concurrently dialysing were excluded. All patients underwent pre procedural medical optimisation by a renal physician (intravenous hydration with normal saline, blood pressure control, withholding ACE Inhibitors, Metformin and Frusemide). Low-osmolality non-ionic contrast diluted to 1/3 strength (group 1) or 1/2 strength (group 2) was used. CIN was defined as creatinine rise of>25% from baseline within 72 hours. Primary outcomewas incidence of CIN. Secondary outcomes were mortality at 6 months, progression to dialysis and long term progression of CKD. Results: 537 patients with CKD stage III-V underwent angiography. 222 patients concurrently dialysing were excluded. Median ages (group 1 n 1⁄4 75, Group 2 n 1⁄4 76, P 1⁄4 0.25) were similar; diabetes was more prevalent in group 1 (70.5%) (group 2 1⁄4 48.4%) (P 1⁄4 0.001) and ischaemic heart disease more prevalent in group 2 (60.0%), (Group 1 1⁄4 44.3%) (P 1⁄4 0.02). Median volume of contrast used was significantly lower for group 1 (n 1⁄4 35 mls, range 2.5 e350 mls) compared to group 2 (n 1⁄4 75 mls, range 20e357) (P < 0.001). Combined incidence of CIN was 3.7%. Incidence of CIN did not differ between groups (group 1 1⁄4 4.1%, group 2 1⁄4 3.2%, P 1⁄4 0.74). No patients with CIN died within 6 months. Follow up ranged from 2e73 months. No patient with CIN progressed to higher CKD stage or dialysis. Conclusion: CIN in CKD population is multifactorial and was not related to volume of contrast used. Pre procedural optimisation of CKD patients and low osmolarity contrast agents may reduce incidence of CIN to a level comparable with the general population. CIN in CKD patients does not lead to death or long term disease progression. Ex-vivo Renal Artery Reconstruction with Kidney Autotransplantation for Renal Artery Branch Aneurysms: Late Results of 67 Procedures B. Chavent, A. Duprey, V. Meyer-Bisch, J.N. Albertini, J.P. Favre, X. Barral, J.B. Ricco University of St Etienne Medical School, France Introduction: The objective of this study was to evaluate the long-term outcome of renal revascularization by ex-vivo renal artery reconstruction and Autotransplantation for Renal Artery Branch Aneurysms (RABA) in view of preventing aneurysm rupture. Methods: From 1991 to 2014, 67 ex-vivo renal artery reconstructions with Kidney Autotransplantation were performed in 58 adults (mean age, 41 years) and in 9 children to repair 87 RABAs. The main underlying disease was fibromuscular dysplasia. The mean diameter of the RABA was 23.4 mm (12e 45 millimetres). Fifty-seven patients were hypertensive and were given a mean of 1.7 antihypertensive drugs per day, 61 patients had normal renal function and no patient was on haemodialysis, 7 patients (10%) were operated after failure of an endovascular procedure. The mean number of renal artery branches repaired per patient was 3.5 and multiple aneurysms were treated in 15 patients (22.3%). The hypogastric artery was used in 41 patients, the saphenous vein in 18 patients, the superficial femoral artery in 5 patients and a combination of different materials in 3 patients. Outcomes consisted in primary patency rates, antihypertensive medication requirements, renal function and mortality. Late graft patency, renal size, and cortical thickness were analyzed by yearly renal duplex ultrasound examinations. Results: One in hospital death (1.5%) occurred in a patient having undergone complex emergent aortic and renal reconstruction. Other perioperative complications included 4 bypass occlusions and one reoperation for bleeding. During a mean follow up of 9 years, 4 patients (6%) were lost to follow up. No other bypass occlusion occurred, while two bypasses required a percutaneous angioplasty. Primary patency and primary assisted patency were respectively 90% and 92.5% at 9 years. Survival was 94% at 9 years. Among the 57 hypertensive patients, 20 (35%) were cured and 14 (25%) were improved at 9 years with a significant reduction of antihypertensive medications (p < .05). Late renal function was preserved as measured by no change in all but 2 patients in estimated glomerular filtration rate compared with pre-intervention values. In addition, there was no difference in treated Kidney size on follow up compared with pre-operative measurements. Conclusion: Ex-vivo renal artery reconstruction for complex renal artery branch aneurysms suppress the risk of rupture, confers a benefit in blood pressure and preserves renal function. Predicting Post-operative Delirium after Vascular Surgical Procedures.
Kenichi Nishiyama - One of the best experts on this subject based on the ideXlab platform.
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effect of synthetic protease inhibitor gabexate mesilate on the attenuation of ischemia reperfusion injury in canine Kidney Autotransplantation
Surgery, 2005Co-Authors: Shigetaka Inoue, Atsushi Sugitani, Hirofumi Yamamoto, Hidehisa Kitada, Kentaro Motoyama, Yasuhiro Okabe, Morihito Ohta, Junichi Yoshida, Kenichi Nishiyama, Masao TanakaAbstract:Background Kidneys from non–heart-beating donors are associated with delayed graft function and a high rejection rate due to the long period of warm ischemia. Gabexate mesilate (GM), a synthetic serine protease inhibitor, has been shown to improve organ function by suppressing cytokine activity and neutrophil function after ischemia/reperfusion. In this study, we evaluated the effect of GM on renal function after warm ischemia in a canine Kidney Autotransplantation model. Methods After 60 minutes of warm ischemia, the left Kidney was transplanted into the iliac fossa, and the right Kidney was removed. The control group (n = 7) and GM group (n = 7) were evaluated for serum creatinine and blood urea nitrogen (BUN) concentrations, renal tissue blood flow, resistive index, pulsatility index, interleukin (IL)-1β and tumor necrosis factor (TNF)-α mRNA expression levels in peripheral blood mononuclear cells, apoptotic index, CD10 immunolabeling as an indicator of brush border injury, and standard histopathology. Results Compared with controls, administration of GM resulted in lower serum creatinine concentrations (11.3 ± 2.4 vs 5.2 ± 3.3 mg/dL at 72 hours; P = .04) and BUN concentrations (188 ± 26 mg/dL vs 98 ± 41 mg/dL at 72 hours; P = .04), as well as better tissue blood flow, improvement of brush border injury and apoptotic index (each P Conclusions The present study shows that GM protected renal function after warm ischemia/reperfusion by inhibition of serine proteases, maintenance of tissue blood flow, and amelioration of tubular apoptosis.
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Effect of synthetic protease inhibitor gabexate mesilate on the attenuation of ischemia/reperfusion injury in canine Kidney Autotransplantation.
Surgery, 2005Co-Authors: Shigetaka Inoue, Atsushi Sugitani, Hirofumi Yamamoto, Hidehisa Kitada, Kentaro Motoyama, Yasuhiro Okabe, Morihito Ohta, Junichi Yoshida, Kenichi Nishiyama, Masao TanakaAbstract:Background Kidneys from non–heart-beating donors are associated with delayed graft function and a high rejection rate due to the long period of warm ischemia. Gabexate mesilate (GM), a synthetic serine protease inhibitor, has been shown to improve organ function by suppressing cytokine activity and neutrophil function after ischemia/reperfusion. In this study, we evaluated the effect of GM on renal function after warm ischemia in a canine Kidney Autotransplantation model. Methods After 60 minutes of warm ischemia, the left Kidney was transplanted into the iliac fossa, and the right Kidney was removed. The control group (n = 7) and GM group (n = 7) were evaluated for serum creatinine and blood urea nitrogen (BUN) concentrations, renal tissue blood flow, resistive index, pulsatility index, interleukin (IL)-1β and tumor necrosis factor (TNF)-α mRNA expression levels in peripheral blood mononuclear cells, apoptotic index, CD10 immunolabeling as an indicator of brush border injury, and standard histopathology. Results Compared with controls, administration of GM resulted in lower serum creatinine concentrations (11.3 ± 2.4 vs 5.2 ± 3.3 mg/dL at 72 hours; P = .04) and BUN concentrations (188 ± 26 mg/dL vs 98 ± 41 mg/dL at 72 hours; P = .04), as well as better tissue blood flow, improvement of brush border injury and apoptotic index (each P Conclusions The present study shows that GM protected renal function after warm ischemia/reperfusion by inhibition of serine proteases, maintenance of tissue blood flow, and amelioration of tubular apoptosis.
Kentaro Motoyama - One of the best experts on this subject based on the ideXlab platform.
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effect of synthetic protease inhibitor gabexate mesilate on the attenuation of ischemia reperfusion injury in canine Kidney Autotransplantation
Surgery, 2005Co-Authors: Shigetaka Inoue, Atsushi Sugitani, Hirofumi Yamamoto, Hidehisa Kitada, Kentaro Motoyama, Yasuhiro Okabe, Morihito Ohta, Junichi Yoshida, Kenichi Nishiyama, Masao TanakaAbstract:Background Kidneys from non–heart-beating donors are associated with delayed graft function and a high rejection rate due to the long period of warm ischemia. Gabexate mesilate (GM), a synthetic serine protease inhibitor, has been shown to improve organ function by suppressing cytokine activity and neutrophil function after ischemia/reperfusion. In this study, we evaluated the effect of GM on renal function after warm ischemia in a canine Kidney Autotransplantation model. Methods After 60 minutes of warm ischemia, the left Kidney was transplanted into the iliac fossa, and the right Kidney was removed. The control group (n = 7) and GM group (n = 7) were evaluated for serum creatinine and blood urea nitrogen (BUN) concentrations, renal tissue blood flow, resistive index, pulsatility index, interleukin (IL)-1β and tumor necrosis factor (TNF)-α mRNA expression levels in peripheral blood mononuclear cells, apoptotic index, CD10 immunolabeling as an indicator of brush border injury, and standard histopathology. Results Compared with controls, administration of GM resulted in lower serum creatinine concentrations (11.3 ± 2.4 vs 5.2 ± 3.3 mg/dL at 72 hours; P = .04) and BUN concentrations (188 ± 26 mg/dL vs 98 ± 41 mg/dL at 72 hours; P = .04), as well as better tissue blood flow, improvement of brush border injury and apoptotic index (each P Conclusions The present study shows that GM protected renal function after warm ischemia/reperfusion by inhibition of serine proteases, maintenance of tissue blood flow, and amelioration of tubular apoptosis.
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Effect of synthetic protease inhibitor gabexate mesilate on the attenuation of ischemia/reperfusion injury in canine Kidney Autotransplantation.
Surgery, 2005Co-Authors: Shigetaka Inoue, Atsushi Sugitani, Hirofumi Yamamoto, Hidehisa Kitada, Kentaro Motoyama, Yasuhiro Okabe, Morihito Ohta, Junichi Yoshida, Kenichi Nishiyama, Masao TanakaAbstract:Background Kidneys from non–heart-beating donors are associated with delayed graft function and a high rejection rate due to the long period of warm ischemia. Gabexate mesilate (GM), a synthetic serine protease inhibitor, has been shown to improve organ function by suppressing cytokine activity and neutrophil function after ischemia/reperfusion. In this study, we evaluated the effect of GM on renal function after warm ischemia in a canine Kidney Autotransplantation model. Methods After 60 minutes of warm ischemia, the left Kidney was transplanted into the iliac fossa, and the right Kidney was removed. The control group (n = 7) and GM group (n = 7) were evaluated for serum creatinine and blood urea nitrogen (BUN) concentrations, renal tissue blood flow, resistive index, pulsatility index, interleukin (IL)-1β and tumor necrosis factor (TNF)-α mRNA expression levels in peripheral blood mononuclear cells, apoptotic index, CD10 immunolabeling as an indicator of brush border injury, and standard histopathology. Results Compared with controls, administration of GM resulted in lower serum creatinine concentrations (11.3 ± 2.4 vs 5.2 ± 3.3 mg/dL at 72 hours; P = .04) and BUN concentrations (188 ± 26 mg/dL vs 98 ± 41 mg/dL at 72 hours; P = .04), as well as better tissue blood flow, improvement of brush border injury and apoptotic index (each P Conclusions The present study shows that GM protected renal function after warm ischemia/reperfusion by inhibition of serine proteases, maintenance of tissue blood flow, and amelioration of tubular apoptosis.
