Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Minimal scar techniques in living donors for kidney transplant

05.08.2011
Hospital Clínic of Barcelona applied this proceeding for the first time in the world to living donors for kidney transplant

Kidney transplant from a living donor, besides of being the best option for young people and those affected by particular conditions, results in increased organ survival and solves in part the organ shortage afflicting Spain since the mid-90 despite the high rate of cadaveric donation.

According to the National Transplant Organization in 2010 in Spain 240 living donor kidney transplants were made, which represents 11% of the total. This year the expectation is that this number will grow to about 300, which would be almost about 13-15% of the total. Given these data and the need to keep looking for new surgical technologies for the improvement of transplantation procedures, the experience of the minimally invasive surgery team at the IDIBAPS - Hospital Clínic of Barcelona has promoted a new way of improvement in living donor programs.

The work presented today at the Catalan hospital by Dr. Antonio Alcaraz. , IDIBAPS investigator and head of the department of Urology at the very center, and his team, confirm the feasibility of surgical techniques with minimal scars (10 and 5 mm) for the extraction of a kidney applied to transplantation. Creators and pioneers in the application of the NOTES technique (Natural Orifice Transluminal Endoscopy Surgery), an approach that aims to conduct surgery through natural orifices of the body, the team led by Dr. Alcaraz applies the modified transvaginal (through the vagina) and transumbilical (through the navel) extraction techniques to kidney transplantation. European Urology magazine published the first World Series of kidney donors by transvaginal nephrectomy surgery with the technique developed in our center.

The medical team at Hospital Clínic which has promoted this milestone and held today a press conference, is formed by Dr. Antonio Alcaraz. , head of the Urology department at the Hospital Clínic, Dr. M ª José Ribal. , head of the Uro-Oncology Unit, Dr. Joan Beltran. , head of the anesthesia section at the Institut Clínic of Obstetrics and Gynecology and the Institut Clínic of Nephrology and Urology, Dr. Mireia Musquera. , responsible for the Kidney Transplant Surgical Unit, and the nurse Marta Tomás. The meeting included the testimony from two donors, male and female, both of them about 60 years old.

The series published by European Urology include 30 women (who have been operated using the NOTES technique); The Hospital Clínic team has operated too four males by the technique called LESS (Laparoscopic-Endoscopic Single-Site Surgery), also known as single port transumbilical surgery. The application of the technique in women (transvaginal nephrectomy) involves two pathways (vagina and abdomen), and two minimal scars (abdomen) of 5 and 10 millimeters. In the case of men (single-port nephrectomy), the pathway is restricted to the navel (which is a scar with a very little vascularization). "The minimally invasive surgical techniques for removal of living donor kidneys have many advantages: better quality of life for the donor, minimal scarring, shorter hospital stay and less pain", says Dr. Alcaraz.

"The surgical technique is completely reproducible and can be considered a good alternative procedure that could increase the rate of living donors among women", said Dr. Alcaraz. According to Dr. Rafael Matesanz, director of the National Transplant Organization (ONT), "it is very important to further enhance this technique, 100% Spanish, because it is the best opportunity for children, young patients with diabetes or renal failure, who need a young kidney the sooner the better".

On his side, Dr. Roser Deulofeu, Director of the Catalan Transplant Organization (OCATT) notes that "the Hospital Clínic and its surgical transplant team turn Catalonia again into a model for the rest the world, making a brilliant and pioneer step forward in surgical techniques that will minimize the physical injury due to a living donor renal extraction and make the recovery process easier".

Strong commitment with minimally invasive surgery

Since conventional open surgery gave way to laparoscopy-assisted surgery - requiring three, four and even five incisions -, pelvic and abdominal cavity surgeons together with robotics experts, investigate new ways to get into the body to explore structures, diagnose diseases and remove organs. Hospital Clínic of Barcelona supports minimally invasive surgery, as shown in today's presentation, and has consolidated its application in living donor transplant.

In 2008 the team led by Dr. Alcaraz performed in Spain the first transumbilical nephrectomy of this kind 85 years cancer diagnosed lady. Three days after the operation the patient went home without problems.

It is the same team that in 2007 performed the first European transvaginal nephrectomy applied to the treatment of a kidney cancer, a minimally invasive technique that made possible the removal of the affected kidney with only two 1 cm incisions in the abdomen, and another hidden one inside the vagina. Since then, Dr. Alcaraz and his team have performed amny kidney withdrawals through the vagina, a pathway that is presented today as a 100% safe and effective alternative for living donor transplants.

Only two or three years ago, Hospital Clínic of Barcelona's Urologists used laparoscopy assisted nephrectomy as the reference technique for the surgical treatment of these pathologies. Although it was a revolutionary and well known technique, which has achieved great results over the past eight years and has improved patient care in terms of postoperative pain and hospital stay, laparoscopy still requires, as in traditional surgery, an abdominal incision to remove the kidney, leaving a scar of approximately 6 centimeters.

Unlike laparoscopy, transvaginal and transumbilical nephrectomy use the vaginal opening and the umbilicus, respectively, to remove kidneys. This technique has managed to avoid external scars and improved patient care, with decreased postoperative pain and a hospital stay under 48 hours. This milestone was possible thanks to an intensive program of research in experimental surgery developed by the Hospital Clínic Urology Department.

With the development of this type of surgery, Hospital Clínic of Barcelona strengthens its position as a reference center for the exploration of new strategies of image-guided surgery. The NOTES program is a revolution with the sole purpose of benefitting the patient with reduced recovery time, reduced pain and no external consequences.

Catalonia, a leader in living donor transplants

OCATT believes the new surgical technique one of many recent successes for Catalonia, a pioneer in transplant organizational model since 1984 and in all types of corneal tissue (1926) and bone marrow (1970) and solid organ transplant: kidney and pancreas (1965 and 1983 in the Clinic), liver and heart (1984 by Bellvitge and Sant Pau hospitals respectively), and lung cancer (1990 at the Hospital Vall d'Hebron).

Catalonia performed, until late 2000s, almost 100% of Spanish living donor transplants through the Hospital Clinic and Puigvert Foundation teams. The OCATT strategic plan approved by the CatSalut in 2004 wanted to increase donation and reduce waiting lists by prioritizing living donor transplantation and heart-beating donation. This strategy, along with a strict control of the effectiveness of the process, facilitated an increase in the number of kidney transplants in Catalonia becoming the main Spanish performer together with the highest rate in the world despite the reduced number of cadaveric donors. Nowadays, 54% of Spanish living donor transplants are made in Catalonia, the crossed transplants involve Catalan donors and recipients and, while 28% of kidney transplants done in Catalonia come from a living donor, only 7% do in Spain.

For more information contact: Hospital Clínic de Barcelona
Department of Communication and Corporate Social Responsibility
María Trenzado, press (trenzado@clinic.ub.es)
Tel: +34932275700 / +34699000516

María Trenzado | EurekAlert!
Further information:
http://www.idibaps.org

More articles from Health and Medicine:

nachricht Penn vet research identifies new target for taming Ebola
12.01.2017 | University of Pennsylvania

nachricht The strange double life of Dab2
10.01.2017 | University of Miami Miller School of Medicine

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

Im Focus: How to inflate a hardened concrete shell with a weight of 80 t

At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).

Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...

Im Focus: Bacterial Pac Man molecule snaps at sugar

Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.

The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

Nothing will happen without batteries making it happen!

05.01.2017 | Event News

 
Latest News

Water - as the underlying driver of the Earth’s carbon cycle

17.01.2017 | Earth Sciences

Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

17.01.2017 | Materials Sciences

Smart homes will “LISTEN” to your voice

17.01.2017 | Architecture and Construction

VideoLinks
B2B-VideoLinks
More VideoLinks >>>