ORCID Profile
0000-0002-7899-1217
Current Organisations
Monash University
,
University of Western Australia
,
Colorado School of Mines
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.TRANSPROCEED.2019.01.034
Abstract: This study was performed to investigate the safety and efficiency of the renal vein "beltization" technique for laparoscopic orthotopic kidney transplantation (LOKT) in a pig model. Kidney autotransplants were conducted, in which the renal vein beltization technique was employed, in 12 domestic pigs. In the operation, the right kidney was autotransplanted to the left kidney vessel trunks. Data of the operative time, venous anastomotic time, vein stenosis, blood loss, kidney graft function, and survival for the pigs were recorded. One week later, the transplanted autograft was removed for observation from the surviving animals while under anesthesia. A silicon tube cage was used to induce hypothermia during laparoscopic operation. All 12 LOKTs were finished. The mean warm ischemia time was 5.22 ± 1.33 minutes, and the mean cold ischemia time was 263.44 ± 50.82 minutes. The mean transplant operative time was 305.67 ± 30.88 minutes. The venous and arterial anastomotic times were 68.42 ± 8.51 minutes and 40.92 ± 9.83 minutes, respectively. After revascularization, an immediate and viable blood supply was seen in 7 grafts based on the appearance of a bright red color. Four pigs urinated immediately after the operation, and 3 produced urine on the next day 4 pigs received life-supporting renal autografts for 7 days. Autopsy results showed 3 artery stenoses and 3 vein stenosis. Thrombi were found in all of these strictured vessels. The median survival time of the pigs was 5.55 days. The renal vein beltization technique may facilitate laparoscopic pig venous anastomotic procedures and ensures the quality of reconstruction. It is helpful for venous anastomoses in LOKT.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2018
Publisher: InTech
Date: 25-07-2018
Publisher: SAGE Publications
Date: 09-05-2021
DOI: 10.1177/17085381211012945
Abstract: During multiple organ procurement, blood vessels are routinely retrieved and stored in University of Wisconsin solution and then discarded after two weeks, if not used at organ transplantation owing to lack of a method for long-term preservation. Therefore, the aim of this study is to investigate a method for long-term preservation of vascular allografts in ethanol. Aorta and vena cava allografts were retrieved and stored in 75% ethanol solution for 12 months at 4°C. Four pigs were ided into two groups. A segment of aorta was excised and replaced by insertion of preserved aorta graft (Group A) or vena cava graft (Group V). The pigs were observed for six weeks. A laparotomy was performed and the vascular graft was harvested for histopathology followed by euthanasia at the end of study. Three pigs recovered uneventfully, while one pig died from venous graft rupture in the third week after surgery. There was no aneurysmal formation or thrombosis in the grafts. Some calcification was seen over aorta allograft. On histopathology, the elastic pattern was almost normal, although the endothelial cells degenerated after preservation. After implantation, the formation of the endothelium cell-like layer was seen in both aorta and vena cava allografts. Vascular allografts were functional after preservation for 12 months. The vena cava grafts had much less wall calcification than the aorta grafts. Further studies are necessary to investigate vascular graft remodelling with a longer observation period after implantation.
Publisher: American Veterinary Medical Association (AVMA)
Date: 07-2017
Publisher: Cureus, Inc.
Date: 20-02-2021
DOI: 10.7759/CUREUS.13459
Publisher: Springer Science and Business Media LLC
Date: 07-12-2017
DOI: 10.1007/S00464-017-5981-3
Abstract: Laparoscopic donor nephrectomy has become the standard of care due to multiple benefits. Currently, there are various techniques employed with two different approaches: transperitoneal (TLDN) or retroperitoneoscopic (RLDN) approach. There is a lack of data to determine which technique is superior, although the RLDN offers an anatomical advantage by avoidance of manipulation of the intraperitoneal organs. The aims of this study were to explore the merits of RLDN to TLDN and assess the learning curve of transition from TLDN to RLDN. From January 2010 to February 2017, 106 live donor nephrectomies were performed: 56 by TLDN and 50 by RLDN. Data on patient demographics, perioperative parameters, analgesic consumption, pain scores, and kidney graft function were collected and analysed. Data were compared with a Student's t test or Mann-Whitney test. A CUSUM analysis was performed to investigate the learning curve. All live donor nephrectomies were successful with no conversion to open surgery. There was no blood transfusion, readmission, or mortality. No postoperative complications were graded over Clavien II. Kidney function was comparable in both groups. The follow-up period ranged from 3 to 78 months. Retroperitoneoscopic live donor nephrectomy is a safe approach with comparable results to TLDN. RLDN has an anatomical advantage as it avoids manipulating the intraperitoneal organs and retains a virgin abdomen and hence translates to a lower perioperative complication risk.
Publisher: Elsevier BV
Date: 08-2014
DOI: 10.1111/AJT.12785
Abstract: The aim of this study is to develop a novel laparoscopic surgery by extra-peritoneal approach for kidney transplant and pave the way of safe transition from laboratory to the clinic. The study was established to explore the feasibility and safety of human laparoscopic kidney transplant. The experiment was first conducted on the deceased animals, then live animals and human cavader before human kidney transplant was approved. The study patient was a 49-year-old male who received the kidney for laparoscopic kidney transplant by extra-peritoneal approach. The control patient received the contralateral kidney for open kidney transplant. The estimated blood loss was minimal during surgery. Both kidneys experienced delayed graft function but the kidneys started function on Day 6 postoperation. The analgesia consumption was significantly less in the study patient. There is no surgical complication during 6-month follow-up. This study has developed a new technique for laparoscopic kidney transplant by extra-peritoneal approach. It has retained the advantages of open kidney transplant, which allows the graft located in the extra-peritoneal space without violating peritoneum. This study has also paved the way of safe transition for a novel laparoscopic surgery from laboratory to the clinic.
Publisher: Frontiers Media SA
Date: 20-07-2020
DOI: 10.1111/TRI.13682
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.TRANSPROCEED.2012.03.054
Abstract: Reconstruction for three renal arteries from a living donor becomes a real challenge as the limited material can be used when compared with deceased donors. Therefore, in this report we introduce a novel technique by using the gonadal vein as a Carrel patch for reconstruction with three renal arteries. The other techniques will also be reviewed in this report. The living donor is a 51-year-old woman with three renal arteries on the left side and one renal artery on the right side, but with early branching 15 mm from the origin. The recipient is her husband, a 56-year-old with end-stage kidney disease secondary to type II diabetes. A left laparoscopic donor nephrectomy was performed successfully. The three renal arteries were anastomosed to the gonadal vein patch in a parallel fashion. Thereafter, the gonadal vein patch was anastomosed to the side of external iliac artery. The renal vein was anastomosed to the side of external iliac vein. The kidney was reperfused rapidly and uniformly. The kidney functioned immediately. Doppler ultrasound and renal nuclear scans revealed that the perfusion of the kidney was normal. The creatinine level was 158 umol/L at day 7 and stable at 140 umol/L during the 2-month follow-up examination. The gonadal vein can be used as a Carrel patch for multiple renal artery reconstruction, in particular, for more than two renal arteries. This technique provides a new approach for the reconstruction of multiple renal arteries in living donor kidney transplantations.
Publisher: SAGE Publications
Date: 14-05-2015
Abstract: Female pigs are commonly utilized as an animal model for biomedical research and require urethral catheterization. Sixteen pigs were anaesthetized for research purposes and required the placement of a urethral catheter. Post-mortem examination of the vaginas revealed the urethral opening to be consistently halfway from the mucocutaneous junction of the vulva to the cervix. A shallow erticulum was also observed on the ventral floor of the urethral opening. To optimize conditions for success the pig should be carefully positioned supine, a vaginal speculum and light source should be used, the pig should be adequately anaesthetized, and the anatomy of the vagina should be reviewed.
Publisher: Baskent University
Date: 04-2017
Abstract: Chyle leak or chylous ascites remains a rare complication after laparoscopic living-donor nephrectomy. Its cause and management have not been well elucidated in the literature. Thus, the aim of this study was to review the incidence of chyle leak/chylous ascites after laparoscopic living-donor nephrectomy in our institute and in the literature to propose a classification system with its associated treatment strategy. In this retrospective review of laparoscopic living-donor nephrectomy patients from January 2005 to April 2016, we identified patients with chyle leak/chylous ascites along with the care performed. A proposed classification system based on our experience and literature is described. Chylous leak developed in 4 donors (2.25%). Of the 4 donors, 3 were treated nonoperatively with diet modification and subcutaneous octreotide injection. One patient required surgical intervention after not responding to second-line therapy with total parenteral nutrition. Chyle leak/chylous ascites after laparoscopic living-donor nephrectomy is rare, but a delayed diagnosis may lead to morbidity secondary to malnutrition and immunosuppression. Meticulous surgical dissection is essential to seal the lymphatic tubes during laparoscopic living-donor nephrectomy. The proposed classification system provides a practical and tailored guide to management based on the drainage volume of chyle leak and a guide to the earlier identification of refractory cases.
Publisher: Baskent University
Date: 04-2013
Abstract: Ureteral stenosis is a common complication after a kidney transplant. Treatment for ureteral stenosis ranges from interventional procedures to open surgery. The aim of this study is to present classification for ureteral stenosis and recommend the targeted strategy for effective treatment. Twelve cases of ureteral stenosis were diagnosed among 193 kidney transplants, of which 91 were from a live donor and 102 from a deceased donor. The mean age was 46.22 ± 13.23 years. The diagnosis of ureteral stenosis includes serum creatinine elevation, hydronephrosis, and presence of stricture on a pyelogram. The criterion for classification is based on the severity of stricture. One of ureteral stenoses was classified as grade 1, six were grade 2, and five were grade 3. Of 12 cases, 10 were live-donor kidney transplant, 4 had lymphocele, and 2 had a hematoma after transplant. The corresponding strategy for each grade of ureteral stenosis is as follows: grade 1, ureteral stent reinsertion grade 2, cutting balloon dilatation or endoscopic incision of stenosis grade 3, open surgery urinary tract reconstruction. All cases were successfully treated using these strategies. This classification of ureteral stenosis provides guidance for effective management and avoids unnecessary procedures. In this series, ureteral stenosis was significantly associated with a live donor and surgical complications.
Publisher: Baskent University
Date: 04-2016
Publisher: MDPI AG
Date: 09-03-2022
DOI: 10.3390/RS14061316
Abstract: The VIIRS day/night band (DNB) high gain stage (HGS) pixel effective dwell time is in the range of 2–3 milliseconds (ms), which is about one third of the flicker cycle present in lighting powered by alternating current. Thus, if flicker is present, it induces random fluctuations in nightly DNB radiances. This results in increased variance in DNB temporal profiles. A survey of flicker characteristics conducted with high-speed camera data collected on a wide range of in idual luminaires found that the flicker is most pronounced in high-intensity discharge (HID) l s, such as high- and low-pressure sodium and metal halides. Flicker is muted, but detectable, in incandescent luminaires. Modern light-emitting diodes (LEDs) and fluorescent lights are often nearly flicker-free, thanks to high-quality voltage smoothing. DNB pixel footprints are about half a square kilometer and can contain vast numbers of in idual luminaires, some of which flicker, while others do not. If many of the flickering lights are drawing from a common AC supplier, the flicker can be synchronized and leave an imprint on the DNB temporal profile. In contrast, multiple power supplies will throw the flickering out of synchronization, resulting in a cacophony with less radiance fluctuation. The examination of DNB temporal profiles for locations before and after the conversion of high-intensity discharge (HID) to LED streetlight conversions shows a reduction in the index of dispersion, calculated by iding the annual variance by the mean. There are a number of variables that contribute to radiance variations in the VIIRS DNB, including the view angle, cloud optical thickness, atmospheric variability, snow cover, lunar illuminance, and the compilation of temporal profiles using pixels whose footprints are not perfectly aligned. It makes sense to adjust the DNB radiance for as many of these extraneous effects as possible. However, none of these adjustments will reduce the radiance instability introduced by flicker. Because flicker is known to affect organisms, including humans, the development of methods to detect and rate the strength of flickering from space will open up new areas of research on the biologic impacts of artificial lighting. Over time, there is a trend towards the reduction of flicker in outdoor lighting through the replacement of HID with low-flicker LED sources. This study indicates that the effects of LED conversions on the brightness and steadiness of outdoor lighting can be analyzed with VIIRS DNB temporal profiles.
Publisher: Informa UK Limited
Date: 09-2013
DOI: 10.2147/TRRM.S50234
Publisher: OMICS Publishing Group
Date: 2016
Publisher: International Scientific Information, Inc.
Date: 27-12-2018
DOI: 10.12659/AOT.913221
Publisher: SAGE Publications
Date: 22-10-2019
Abstract: Fifty-four pigs ( Sus scrofa, Large White cross) from a commercial pig farm were anaesthetised over a six-year period from October 2011. The procedural stages included initial instrumentation for intra-operative monitoring, laparoscopic nephrectomy, preparation of the kidney graft, orthotopic auto-transplantation by either a laparoscopic approach or an open surgical approach, and ligation of the contralateral ureter. During the evolution and establishment of this pig model multiple refinements were introduced: (1) a heat pad was changed to a circulating warm air blanket (2) routine administration of anticholinesterase and antimuscarinic drugs for reversal of neuromuscular blockade (3) a technique for urethral catheterisation was developed (4) ultrasound guidance for placement of a central venous line was learned (5) intravenous infusions of morphine and ketamine were instituted for a more stable and balanced anaesthetic protocol and (6) post-operative monitoring was performed by two technical staff for at least the first six hours after extubation of the trachea. The combination of refinements to the anaesthesia protocol for laparoscopic orthotopic kidney auto-transplantation over the first 54 pigs has translated to improved outcomes. This conclusion is entirely subjective as accurate measurement of the impact of each refinement is impossible. Nevertheless, refinement is a continuous process and should be applied to the entire range of procedures involved in animal use for scientific purposes.
Publisher: International Scientific Information, Inc.
Date: 2012
DOI: 10.12659/AOT.882635
Abstract: Renal allograft rupture (RAR) is a rare complication, but it can cause graft loss and be life-threatening. Surgical exploration and repair is essential for saving the kidney graft. The aim of this article is to describe a novel suture-free technique for management of RAR. Twenty-six RARs were diagnosed in 1851 kidney transplants from November 2002 to November 2008. The study was ided into 2 groups: a suture group and a suture-free group. Twelve cases were treated in the suture group, whereas 14 were treated by the suture-free technique. In the suture-free group, absorbable thread was used to bundle the ruptured renal graft. For the suture group, autologous cubic muscular tissues or external oblique aponeurosis were used as pledgets. In the suture-free group all 14 grafts were rescued with creatinine (Cr) at 1.8 ± 0.62 mg/dl on discharge. In the suture group all 12 grafts were repaired successfully with Cr 1.9 ± 0.63 mg/dl on discharge. The 1-, 3- and 5-year graft survival rate was 92.8%, 82.5%, 70.50%, respectively, in the suture-free group and 84.1%, 75.5%, 67.4%, respectively, in the suture group. The suture-free technique had shorter operation time, less blood transfusion and shorter hospital stay. The suture-free technique is a safe and effective technique for treatment of RAR, with advantages of shorter operating time, less blood loss and quicker recovery after surgery.
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.JSS.2017.09.042
Abstract: Laparoscopic live donor nephrectomy has replaced open donor nephrectomy in most patients due to numerous benefits. A live animal model is required to equip surgeons with the necessary skills to perform such a procedure with minimal risk of complications. The aim of this study was to establish the technique for laparoscopic live donor nephrectomy in a porcine (Sus scrofa) model. This study was approved by the Animal Ethics Committee of the university. Forty-four pigs underwent laparoscopic live donor nephrectomy. The left kidney was removed with a standardized four-port technique, with a small suprapubic incision to facilitate kidney delivery. All 44 procedures were performed successfully, with no intraoperative complications or conversion to open surgery. There was no apparent damage to any of the kidney grafts. The mean surgical time was 118.3 (±20.7) minutes. There was a small, but statistically insignificant, decrease in surgical time throughout the duration of the study. Several subjects had minor variations in the anatomy of the renal vasculature. This series has developed and proven a training model for laparoscopic donor nephrectomy in pigs. This training model will allow surgeons to develop laparoscopic proficiency in a live donor, to be used in conjunction with human cadaveric training.
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.TRANSPROCEED.2012.12.013
Abstract: The aims of this study were to provide an overview of techniques for renal artery reconstruction and to introduce a novel technique using the gonadal vein as a "Carrel patch." From January 2005 to December 2011, we performed 128 live donor kidney transplantations. All donor nephrectomies used laparoscopic surgery, yielding 23 grafts with 2 and 3 with 3 renal arteries. The reconstruction technique was based on the length and caliber of the arteries. For 3 renal arteries, we used the gonadal vein as a "Carrel patch". The gonadal vein was harvested with the ureter as a bundle during nephrectomy. The recipients were 1.5 to 71 years old (average, 43.9). All laparoscopic donor nephrectomies were performed successfully with preservation of the multiple arteries. The reconstructions were satisfactory all grafts functioned immediately. There was no arterial infarction on postoperative Doppler ultrasound and renal nuclear scan. Renal artery stenosis occurred in 2 cases, in which the interventional balloon dilatation was first used 1 case required subsequent stent insertion. In cases of multiple renal arteries, the live donor kidney can be recovered safely by laparoscopic surgery. Our technique to reconstruct multiple renal arteries uses the gonadal vein as a "Carrel patch." The gonadal vein is readily available during laparoscopic donor nephrectomy.
Publisher: Baskent University
Date: 24-01-2014
Abstract: To evaluate the technique of laparoscopic kidney transplant and demonstrate the feasibility of this procedure by an extraperitoneal approach. The procedure was performed on 2 human cadavers. Retroperitoneal endoscopic left nephrectomy was performed. An extraperitoneal space was established by inflation of a balloon dilator. The external iliac artery and vein were exposed. A Pfannenstiel incision (6 cm) was made and a hand-access device was used. The renal artery was anastomosed to the external iliac artery (end-to-side anastomosis) the renal vein was anastomosed to the external iliac vein (end-to-side anastomosis). The ureter was anastomosed to the bladder with an extravesical tunnelling technique. The donor kidney grafts were obtained successfully. The preparation of the external iliac artery and vein was satisfactory. The entire procedure for the renal artery, renal vein, and ureteral anastomoses was performed with laparoscopic technique without any difficulty. The present model on human cadavers may provide a feasible approach for training surgeons to perform human laparoscopic kidney transplant. The present technique may be applied to clinical human kidney transplant.
Publisher: Public Library of Science (PLoS)
Date: 08-01-2014
Publisher: Baskent University
Date: 10-2017
Abstract: There are increased reports that kidney transplant can be performed by laparoscopic surgery. The further development of this technique could revolutionize human kidney transplant surgery. However, laparoscopic kidney transplant demands a high level of skill for vascular anastomoses. The emerging technology of the three-dimensional, high-definition laparoscopic system may facilitate the application of this technique. Therefore, in this study, we evaluated this system in performing kidney transplant surgery versus the two-dimensional laparoscopic system. Four fresh-frozen human cadavers were used in this study, with 2 for the 3-dimensional and 2 for the 2-dimensional system. Kidneys were retrieved by using the retroperitoneoscopic technique for living donor nephrectomy from the same cadaver. The kidney graft was transplanted at the right iliac fossa using a laparoscopic technique by extraperitoneal approach. The procedure was recorded, and the vessel anastomotic time was analyzed. Kidney transplant procedures were conducted successfully in the 3-dimensional, high-definition and the 2-dimensional groups. We recorded no significant differences in terms of vessel anastomotic time between the 2 groups. The total surgery time was shorter in the 3-dimensional, high-definition group than in the 2-dimensional group (P = .02). This pilot study reinforces that kidney transplant with either the 3-dimensional, high-definition or 2-dimensional laparoscopy is feasible in a human cadaveric model. The operation was the same as open kidney transplant, but the procedure was performed by a laparoscopic approach with a smaller incision.
Publisher: Elsevier BV
Date: 05-2015
DOI: 10.1111/AJT.13228
Publisher: Baskent University
Date: 02-2021
Publisher: Peertechz Publications Private Limited
Date: 27-04-2015
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.TRANSPROCEED.2013.01.056
Abstract: Laparoscopic surgery has rapidly expanded in clinical practice replacing conventional open surgery over the last three decades. Laparoscopic donor nephrectomy has been favored due to its multiple benefits. The aim of this study was to explore the safety and feasibility of kidney transplantation by a laparoscopic technique in a pig model. The study was approved by the university animal ethics committee. Eight female pigs (Sus Scrofra, weighing 45-50 kg) were ided into 2 groups: group I included 4 animals that underwent laparoscopic kidney orthotopic transplantation on the left side. The right kidney was remained functional in situ. The pigs recovered and were observed for 1 week. In the 4 hosts group II pigs underwent a laparoscopic kidney transplantation on the left side. With simultaneous clipping of the right ureter. After recovery, the pigs were observed for 4 weeks. A laparotomy for examination was performed prior to euthanasia. All 4 group I pigs survived for 1 week. The laparotomy showed normal graft perfusion with wall patent renal artery and vein as well as satisfactory urine output upon transection of ureter in 3 hosts. Renal artery stenosis occurred in one pig. In The Immediate kidney graft function was achieved in 3 group II pigs. The fourth died following extubation due to laryngospasm despite a functional graft. The average creatinine levels were 195.5 μmol/L on day 3 224.5 μmol/L at week 1 127 μmol/L at week 2 182.7 umol/L at week 3 and 154.7 umol/L at week 4. Laparoscopic kidney transplantation was feasible and safe in a pig model with immediate graft function. This study will provide further evidence to support application of laparoscopic technique to human kidney transplant.
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.TRANSPROCEED.2012.05.078
Abstract: Laparoscopic donor nephrectomy has been widely accepted in living donor kidney transplantation. Ectopic kidneys are sometimes encountered during the living donor workup. Ectopic kidneys have been utilized successfully for kidney transplant. However, all these donor nephrectomies were performed by open surgery. We report a successful case of laparoscopic donor nephrectomy for ectopic kidney. The literature was reviewed and the technique points were emphasized.
Publisher: Elsevier BV
Date: 10-2013
DOI: 10.1016/J.JSS.2013.03.015
Abstract: Laparoscopic surgery has become the preferred approach in surgical practice due to multiple benefits. Over the last decade, kidney transplant by laparoscopic or robotic techniques have been explored. The aim of this study is to establish a new laparoscopic technique for kidney orthotopic transplant. The study was approved by the Animal Ethics Committee of the University. Ten live female pigs (Sus scrofa), weighing 45-50 kg, underwent laparoscopic kidney orthotopic transplant on left side under general anesthesia, and the opposite right kidney was defunctioned by complete ligation of the ureter at the same time. The vital signs of all pigs were stable during the surgery and postoperative period. There were no intraoperative complications and no conversion to open surgery. The laparoscopic kidney transplant was successful in seven of 10 pigs. Seven pigs were observed up to 4 wk as planned in the study. To our knowledge, this is the first study of laparoscopic kidney orthotopic transplant in pig model with satisfactory immediate graft function. It was demonstrated that laparoscopic kidney transplant is a feasible, reliable, and safe procedure. However, it is a very demanding technique. Adequate training is mandatory for performing laparoscopic kidney transplant. This study could be used as a training model for surgeons who wish to perform human laparoscopic kidney transplant in the future.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2018
Publisher: Springer Science and Business Media LLC
Date: 03-08-2017
Publisher: Informa UK Limited
Date: 05-2016
DOI: 10.2147/TRRM.S94868
No related grants have been discovered for Bulang He.