As a member of my hospital's interventional radiology (IR) trauma team, I was directly involved in numerous organ embolizations and three organ procurements. Both procedures presented multiple challenges, however none could be more daunting than the process of prepping a kidney for a transplant. This process can be done through traditional invasive methods by directly severing the blood supply to the kidney or using a much more delicate approach known as fluoroscopic embolization.
Fluoroscopic embolization is the process of using fluoroscopy, a constant controlled dose of radiation, to visually locate the arterial blood supply of a target organ and stopping the arterial blood flow to that organ. This is a minimally invasive preparatory step to the eventual complete removal of the kidney.
New studies have proven that this approach done before the extraction and transplant of the kidney will result in a better overall outcome for both the donor and recipient. This is simply due to the significant decrease in blood loss associated with the transplant and extraction procedures. Though this method does result in an increased healing time, the overall success and organ viability rate has increased.
During my time with the IR trauma team, I have assisted with this procedure multiple times and I have seen the results first hand to know that this is a much safer and overall healthier option for patients.
Yeast, C., Riley, J. M., Holyoak, J., Ross, G., Weinstein, S., & Wakefield, M. (2016). Use of preoperative embolization prior to Transplant nephrectomy. Retrieved October 13, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4811234/
Your experiences sound extremely interesting and fulfilling. Though I have heard of the use of embolizations, I did not know about the implications of using them preoperatively. Why do they result in an increased healing time and how is the blood flow restored once the surgery is completed?
ReplyDeleteYour post led me to do more research about this technique and in doing so I found an interesting article about the use of preoperative embolization on patients with hypervascular spinal metastasis. This shocked me since the nervous system is so intricate and delicate. I did not think that preoperative embolization would be used on the spine due to what I would imagine would be a large amount associated risks. I am sure that the use of this technique requires extensive training and great care so as to not permanently debilitate the patient.
Lim, K.Z., Goldschlager, T., Chandra, R.V. (2017). Pre-operative embolization of hypervascular spinal metastasis using percutaneous direct intratumoural injection with Onyx under local anesthesia. Journal of Clinical Neuroscience, 44, 306-309.