warm ischemia


Summary: A tissue or organ remaining at physiological temperature during decreased BLOOD perfusion or in the absence of blood supply. During ORGAN TRANSPLANTATION it begins when the organ reaches physiological temperature before the completion of SURGICAL ANASTOMOSIS and ends with reestablishment of the BLOOD CIRCULATION through the tissue.

Top Publications

  1. Choi J, Park J, Lee S, Jeong B, Jeon S, Lee H, et al. Does prolonged warm ischemia after partial nephrectomy under pneumoperitoneum cause irreversible damage to the affected kidney?. J Urol. 2012;187:802-6 pubmed publisher
    We determined the effects of warm ischemia time on the recovery of renal function after partial nephrectomy under pneumoperitoneum...
  2. Ohsumi A, Chen F, Sakamoto J, Nakajima D, Hijiya K, Motoyama H, et al. Protective effect of pre-recovery surfactant inhalation on lungs donated after cardiac death in a canine lung transplantation model. J Heart Lung Transplant. 2012;31:1136-42 pubmed publisher
    b>Warm ischemia-reperfusion injury related to donation after cardiac death is a crucial issue in transplantation...
  3. Ohsumi A, Chen F, Nakajima D, Sakamoto J, Yamada T, Fujinaga T, et al. Therapeutic effect of surfactant inhalation during warm ischemia in an isolated rat lung perfusion model. Transpl Int. 2012;25:1096-105 pubmed publisher
    b>Warm ischemia-reperfusion injury related to donation after cardiac death donors is a crucial and inevitable issue...
  4. Perk S, Izamis M, Tolboom H, Uygun B, Yarmush M, Uygun K. A fitness index for transplantation of machine-perfused cadaveric rat livers. BMC Res Notes. 2012;5:325 pubmed publisher
  5. Tolboom H, Pouw R, Izamis M, Milwid J, Sharma N, Soto Gutierrez A, et al. Recovery of warm ischemic rat liver grafts by normothermic extracorporeal perfusion. Transplantation. 2009;87:170-7 pubmed publisher
    ..Livers recovered from male Lewis rats were subjected to 1 hr of warm ischemia and preserved with 5 hr of SCS or NELP, and transplanted into syngeneic recipients...
  6. Tolboom H, Izamis M, Sharma N, Milwid J, Uygun B, Berthiaume F, et al. Subnormothermic machine perfusion at both 20°C and 30°C recovers ischemic rat livers for successful transplantation. J Surg Res. 2012;175:149-56 pubmed publisher
    ..Livers from male Lewis rats were divided into five groups after 1 h of warm ischemia (WI): (1) WI only, (2) 5 h of static cold storage (SCS), or 5 h of MP at (3) 20°C, (4) 30°C, and (5) 37°C...
  7. Ichiki A, Miyazaki T, Nodera M, Suzuki H, Yanagisawa H. Ascorbate inhibits apoptosis of Kupffer cells during warm ischemia/reperfusion injury. Hepatogastroenterology. 2008;55:338-44 pubmed
    ..cells consisting of hepatocytes, Kupffer cells, and sinusoidal endothelial cells (SECs) in the rat liver after warm ischemia/reperfusion (I/R) injury...
  8. Siedlecki A, Irish W, Brennan D. Delayed graft function in the kidney transplant. Am J Transplant. 2011;11:2279-96 pubmed publisher
    ..Future success in suppressing the development of DGF will require a concerted effort to anticipate and treat tissue injury throughout the arc of the transplantation process. ..
  9. Sakamoto J, Chen F, Nakajima D, Yamada T, Ohsumi A, Zhao X, et al. The effect of ?-2 adrenoreceptor agonist inhalation on lungs donated after cardiac death in a canine lung transplantation model. J Heart Lung Transplant. 2012;31:773-9 pubmed publisher
    ..Histologic findings revealed that the ?-2 group had less edema and fewer inflammatory cells. Our results suggest that ?-2 adrenoreceptor agonist inhalation during the pre-procurement period may ameliorate IRI. ..

More Information


  1. Jeyabalan G, Klune J, Nakao A, Martik N, Wu G, Tsung A, et al. Arginase blockade protects against hepatic damage in warm ischemia-reperfusion. Nitric Oxide. 2008;19:29-35 pubmed publisher
    ..Arginase blockade represents a potentially novel strategy to combat liver injury under conditions of arginine deficiency. This protection may be mediated through the arginine-NO pathway. ..
  2. Cau J, Favreau F, Tillement J, Lerman L, Hauet T, Goujon J. Trimetazidine reduces early and long-term effects of experimental renal warm ischemia: a dose effect study. J Vasc Surg. 2008;47:852-860 pubmed publisher
    ..TMZ) is a drug, the protective effects of which have been already assessed during cold preservation and warm ischemia (WI). The objective of this dose-effect study was to assess the role of TMZ in severe renal WI model...
  3. Wang M, Jin Z, Chen D, Li X, Zhao X, Fan H. Risk factors of severe ischemic biliary complications after liver transplantation. Hepatobiliary Pancreat Dis Int. 2011;10:374-9 pubmed
    ..Linear regression demonstrated a negative correlation between cold preservation time and warm ischemia time...
  4. Doucet C, Zhang K, Desurmont T, Hebrard W, Scepi M, Nadeau C, et al. Influence of warm ischemia time on peripheral-type benzodiazepine receptor: a new aspect of the role of mitochondria. Nephron Exp Nephrol. 2007;107:e1-11 pubmed
    ..We have studied the influence of different durations of warm ischemia (WI) on renal function, tissue damage and PBR expression in a Large Whitepig model...
  5. Halazun K, Al Mukhtar A, Aldouri A, Willis S, Ahmad N. Warm ischemia in transplantation: search for a consensus definition. Transplant Proc. 2007;39:1329-31 pubmed
    quot;Warm ischemia" is a term used to describe ischemia of cells and tissues under normothermic conditions...
  6. Dutkowski P, Furrer K, Tian Y, Graf R, Clavien P. Novel short-term hypothermic oxygenated perfusion (HOPE) system prevents injury in rat liver graft from non-heart beating donor. Ann Surg. 2006;244:968-76; discussion 976-7 pubmed
    ..After orthotopic liver transplantation, grafts treated by HOPE demonstrated a significant extension on animal survival. We demonstrate a beneficial effect of HOPE by preventing reperfusion injury in a clinically relevant NHBD model. ..
  7. Fujinaga T, Nakamura T, Fukuse T, Chen F, Zhang J, Ueda S, et al. Isoflurane inhalation after circulatory arrest protects against warm ischemia reperfusion injury of the lungs. Transplantation. 2006;82:1168-74 pubmed
    ..In the current study, we investigated whether isoflurane inhalation during warm ischemia could attenuate ischemia reperfusion injury (IRI) of the lung. An isolated perfused rat lung model was used...
  8. Dorn C, Massinger S, Wuzik A, Heilmann J, Hellerbrand C. Xanthohumol suppresses inflammatory response to warm ischemia-reperfusion induced liver injury. Exp Mol Pathol. 2013;94:10-6 pubmed publisher
    ..In conclusion, these data indicate the potential of xanthohumol application to prevent adverse inflammatory responses to I/R-induced liver damage such as after surgical liver resection or transplantation. ..
  9. Srinivasan P, Yagi S, Doorschodt B, Nagai K, Afify M, Uemoto S, et al. Impact of venous systemic oxygen persufflation supplemented with nitric oxide gas on cold-stored, warm ischemia-damaged experimental liver grafts. Liver Transpl. 2012;18:219-25 pubmed publisher
    ..systemic oxygen persufflation (VSOP) supplemented with nitric oxide (NO) gas during the cold storage (CS) of warm ischemia (WI)-damaged experimental liver grafts...
  10. Kannerup A, Grønbaek H, Funch Jensen P, Tønnesen E, Jørgensen R, Mortensen F. Cytokine changes during warm ischemia and reperfusion of the pig liver with or without preconditioning. Eur Surg Res. 2009;42:216-22 pubmed publisher
    ..IL-6 increased significantly in the IPC group compared to the non-IPC group, while the opposite was observed for TNF-alpha. These cytokine changes may be involved in the hepatoprotective mechanism induced by IPC. ..
  11. Lane B, Russo P, Uzzo R, Hernandez A, Boorjian S, Thompson R, et al. Comparison of cold and warm ischemia during partial nephrectomy in 660 solitary kidneys reveals predominant role of nonmodifiable factors in determining ultimate renal function. J Urol. 2011;185:421-7 pubmed publisher
    ..that determine renal function after partial nephrectomy are not well-defined, including the impact of cold vs warm ischemia, and the relative importance of modifiable and nonmodifiable factors...
  12. Cag M, Audet M, Saouli A, Panaro F, Piardi T, Cinqualbre J, et al. Does arterialisation time influence biliary tract complications after orthotopic liver transplantation?. Transplant Proc. 2010;42:3630-3 pubmed publisher
    ..about ischemic reperfusion injury owing to the exclusive arterial vascularization of the biliary tree, the warm ischemia time has been implicated as responsible for biliary lesions during organ procurement...
  13. Thompson R, Lane B, Lohse C, Leibovich B, Fergany A, Frank I, et al. Comparison of warm ischemia versus no ischemia during partial nephrectomy on a solitary kidney. Eur Urol. 2010;58:331-6 pubmed publisher
    The safe duration of warm ischemia during partial nephrectomy (PN) remains controversial. To compare the short- and long-term renal effects of warm ischemia versus no ischemia in patients with a solitary kidney...
  14. Jin L, Liu Y, Zhou L, Xie H, Feng X, Li H, et al. Ischemic preconditioning attenuates morphological and biochemical changes in hepatic ischemia/reperfusion in rats. Pathobiology. 2010;77:136-46 pubmed publisher
    ..However, the protective effects of IPC on hepatic warm ischemia/reperfusion (I/R) injury and the potential mechanisms involved are not fully understood...
  15. Funahashi Y, Hattori R, Yamamoto T, Sassa N, Fujita T, Gotoh M. Effect of warm ischemia on renal function during partial nephrectomy: assessment with new 99mTc-mercaptoacetyltriglycine scintigraphy parameter. Urology. 2012;79:160-4 pubmed publisher
    ..This new parameter quantified ischemic renal damage better than the conventional split functional evaluation. When warm ischemic time was ?25 minutes, irreversible diffuse damage was seen in surgically preserved nephrons. ..
  16. Liu A, Dirsch O, Fang H, Dong W, Jin H, Huang H, et al. HMGB1 translocation and expression is caused by warm ischemia reperfusion injury, but not by partial hepatectomy in rats. Exp Mol Pathol. 2011;91:502-8 pubmed publisher
    ..Mechanic injury in hepatic surgery is associated with focal warm ischemia, and thereby HMGB1 translocation reflects surgical quality in experimental PH...
  17. Liang R, Nickkholgh A, Kern M, Schneider H, Benzing S, Zorn M, et al. Green tea extract ameliorates reperfusion injury to rat livers after warm ischemia in a dose-dependent manner. Mol Nutr Food Res. 2011;55:855-63 pubmed publisher
    ..Sprague-Dawley rats were gavaged with different concentrations of green tea extract (GTE) 2 h before 90 min of warm ischemia of the left lateral liver lobe (30% of liver). Controls were given the same volume of Ringer's solution...
  18. de Souza D, de Oliveira L, da Cruz M, Abílio E, Costa W, Pereira Sampaio M, et al. Laparoscopic partial nephrectomy under warm ischemia reduces the glomerular density in a pig model. J Endourol. 2012;26:706-10 pubmed publisher
    To investigate the number of nephrons, using unbiased stereological method, after warm ischemia for laparoscopic partial nephrectomy in a pig model...
  19. Cohen J, Dorai T, Ding C, Batinic Haberle I, Grasso M. The administration of renoprotective agents extends warm ischemia in a rat model. J Endourol. 2013;27:343-8 pubmed publisher
    Extended warm ischemia time during partial nephrectomy leads to considerable renal injury...
  20. Jayle C, Favreau F, Zhang K, Doucet C, Goujon J, Hebrard W, et al. Comparison of protective effects of trimetazidine against experimental warm ischemia of different durations: early and long-term effects in a pig kidney model. Am J Physiol Renal Physiol. 2007;292:F1082-93 pubmed
    ..b>Warm ischemia (WI) is a crucial factor of tissue damage, and tissue destruction led by ischemia-reperfusion (I/R) can impact ..
  21. Simforoosh N, Basiri A, Shakhssalim N, Ziaee S, Tabibi A, Moghaddam S. Effect of warm ischemia on graft outcome in laparoscopic donor nephrectomy. J Endourol. 2006;20:895-8 pubmed
    To assess the impact of warm ischemia time (WIT) on delayed graft function (DGF), graft loss, and graft function in laparoscopic donor nephrectomy (LDN). We prospectively studied 100 kidney recipients from LDN donors from 2001 to 2003...
  22. Phillips C, Hruby G, Mirabile G, Motamedinia P, Lehman D, Okhunov Z, et al. Erythropoietin-induced optimization of renal function after warm ischemia. J Endourol. 2009;23:359-65 pubmed publisher
    ..The current study demonstrates that administering Epo before warm ischemia can improve the recovery of renal function after ischemia better than placebo or mannitol.
  23. Nogueira J, Haririan A, Jacobs S, Weir M, Hurley H, Al Qudah H, et al. The detrimental effect of poor early graft function after laparoscopic live donor nephrectomy on graft outcomes. Am J Transplant. 2009;9:337-47 pubmed publisher
    ..001). Risk factors for poor DGF included advanced donor age, high recipient BMI, sirolimus use and prolonged warm ischemia time...
  24. de Rougemont O, Breitenstein S, Leskosek B, Weber A, Graf R, Clavien P, et al. One hour hypothermic oxygenated perfusion (HOPE) protects nonviable liver allografts donated after cardiac death. Ann Surg. 2009;250:674-83 pubmed publisher
    ..This is the first study in a reliable large animal transplant model demonstrating the efficacy of a simple cold oxygenated machine perfusion system to rescue, otherwise lethal, ischemic injured DCD liver grafts. ..
  25. Shen S, Zhang Y, Xiang J, Xiong C. Protective effect of curcumin against liver warm ischemia/reperfusion injury in rat model is associated with regulation of heat shock protein and antioxidant enzymes. World J Gastroenterol. 2007;13:1953-61 pubmed
    To investigate the hypothesis that the protective effects of curcumin in hepatic warm ischemia/reperfusion (I/R) injury are associated with increasing heat shock protein 70 (Hsp70) expression and antioxidant enzyme activity...
  26. Fondevila C, Hessheimer A, Maathuis M, Munoz J, Taura P, Calatayud D, et al. Superior preservation of DCD livers with continuous normothermic perfusion. Ann Surg. 2011;254:1000-7 pubmed publisher
    ..Although 60 minutes recuperative NECMO is better than CS alone, NMP improves further on NECMO and may have a role in preserving DCD livers in the clinical setting. ..
  27. Inci I, Arni S, Acevedo C, Jungraithmayr W, Inci D, Vogt P, et al. Surfactant alterations following donation after cardiac death donor lungs. Transpl Int. 2011;24:78-84 pubmed publisher
    ..BAL protein, surface tension, adsorption, peak AWP and PVR increase significantly after 2 h of warm ischemia together with a significant reduction of the ratio PaO(2)/FiO(2).
  28. Godoy G, Ramanathan V, Kanofsky J, O Malley R, Tareen B, Taneja S, et al. Effect of warm ischemia time during laparoscopic partial nephrectomy on early postoperative glomerular filtration rate. J Urol. 2009;181:2438-43; discussion 2443-5 pubmed publisher
    We evaluated the effect of warm ischemia time on early postoperative renal function following laparoscopic partial nephrectomy...
  29. Miyagi S, Iwane T, Akamatsu Y, Nakamura A, Sato A, Satomi S. The significance of preserving the energy status and microcirculation in liver grafts from non-heart-beating donor. Cell Transplant. 2008;17:173-8 pubmed
    ..Rats were allocated to six groups as follows (n=5): (i) control group-no warm ischemia (WI) and cold preservation, (ii) HBD group--no WI with cold preservation for 6 h; (iii) NHBD group--with 30 ..
  30. Hong J, Koroleff D, Xia V, Chang C, Duarte S, Xu J, et al. Regulated hepatic reperfusion mitigates ischemia-reperfusion injury and improves survival after prolonged liver warm ischemia: a pilot study on a novel concept of organ resuscitation in a large animal model. J Am Coll Surg. 2012;214:505-15; discussion 515-6 pubmed publisher
    ..We investigate the use of RHR in mitigating IRI after a prolonged period of warm ischemia. Using a 2-hour liver warm ischemia swine model, 2 methods of liver reperfusion were compared...
  31. Thompson R, Lane B, Lohse C, Leibovich B, Fergany A, Frank I, et al. Renal function after partial nephrectomy: effect of warm ischemia relative to quantity and quality of preserved kidney. Urology. 2012;79:356-60 pubmed publisher
    To evaluate the effects of warm ischemia time (WIT) and quantity and quality of kidney preserved on renal functional recovery after partial nephrectomy (PN)...
  32. Ficarra V, Bhayani S, Porter J, Buffi N, Lee R, Cestari A, et al. Predictors of warm ischemia time and perioperative complications in a multicenter, international series of robot-assisted partial nephrectomy. Eur Urol. 2012;61:395-402 pubmed publisher
    b>Warm ischemia time (WIT) and complication rates are two important parameters for evaluating the perioperative results of robot-assisted partial nephrectomy (RAPN)...
  33. Lane B, Gill I, Fergany A, Larson B, Campbell S. Limited warm ischemia during elective partial nephrectomy has only a marginal impact on renal functional outcomes. J Urol. 2011;185:1598-603 pubmed publisher
    Ischemic damage during partial nephrectomy increases with each minute of warm ischemia, leading some groups to advocate hypothermia in all cases or partial nephrectomy without vascular occlusion as a primary technique...
  34. Zhao H, Zhang G, Zhou J, Lin J, Cui Z, Li X. Biliary tract injury caused by different relative warm ischemia time in liver transplantation in rats. Hepatobiliary Pancreat Dis Int. 2009;8:247-54 pubmed
    There is a controversy over the degree of liver and biliary injury caused by the period of secondary warm ischemia. A liver autotransplantation model was adopted because it excludes the effects of infection and immunological rejection on ..
  35. Ellett J, Evans Z, Atkinson C, Schmidt M, Schnellmann R, Chavin K. Toll-like receptor 4 is a key mediator of murine steatotic liver warm ischemia/reperfusion injury. Liver Transpl. 2009;15:1101-9 pubmed publisher
    ..In conclusion, these improvements in liver function in TLR4KO HFD animals implicate TLR4 as a mediator of steatotic graft failure after I/R. ..
  36. Vogel T, Brockmann J, Friend P. Ex-vivo normothermic liver perfusion: an update. Curr Opin Organ Transplant. 2010;15:167-72 pubmed publisher
    ..The current challenges are, first to confirm the feasibility of the normothermic machine perfusion methodology in human livers and, second, to develop and introduce a functional device into the clinical arena. ..
  37. Hellegering J, Visser J, Kloke H, d Ancona F, Hoitsma A, van der Vliet J, et al. Deleterious influence of prolonged warm ischemia in living donor kidney transplantation. Transplant Proc. 2012;44:1222-6 pubmed publisher
    ..investigating early graft function (EGF) after living donor kidney transplantation (LDKT) identified prolonged warm ischemia time (WIT) as a risk factor for the occurrence of poor EGF...
  38. Vician M, Olejnik J, Michalka P, Jakubovsky J, Brychta I, Gergel M. Warm liver ischemia in experiment and lysosomal markers. Bratisl Lek Listy. 2009;110:587-91 pubmed
    ..study is to perform a morphological analysis of certain lysosomal enzymes and parenchymal alterations during warm ischemia in the pig liver. Standard hepatectomies were performed in a set of 24 pigs...
  39. Kon Z, Brown E, Grant M, Ozeki T, Burris N, Collins M, et al. Warm ischemia provokes inflammation and regional hypercoagulability within the heart during off-pump coronary artery bypass: a possible target for serine protease inhibition. Eur J Cardiothorac Surg. 2008;33:215-21 pubmed
    ..Aprotinin, but not other factors that influence the coagulation system, appears to mitigate this process during OPCAB. ..
  40. Ban D, Kudo A, Sui S, Tanaka S, Nakamura N, Ito K, et al. Decreased Mrp2-dependent bile flow in the post-warm ischemic rat liver. J Surg Res. 2009;153:310-6 pubmed publisher
    The link between microcirculatory disturbance and hepatocellular dysfunction remains unknown. The present study was designed to examine the key event of warm ischemia reperfusion (WIR) injury with subsequent cholestasis.
  41. Ma Y, Dai H, Kong X. Impact of warm ischemia on gene expression analysis in surgically removed biosamples. Anal Biochem. 2012;423:229-35 pubmed publisher
    ..b>Warm ischemia resulting from these factors has a substantial effect on biosample quality and is the focus of this mini ..
  42. De Oliveira N, Osaki S, Maloney J, Meyer K, Kohmoto T, D Alessandro A, et al. Lung transplantation with donation after cardiac death donors: long-term follow-up in a single center. J Thorac Cardiovasc Surg. 2010;139:1306-15 pubmed publisher
    ..Our findings suggest that the use of donation after cardiac death donors can safely and substantially expand the donor pool for lung transplantation. ..
  43. Perk S, Izamis M, Tolboom H, Uygun B, Berthiaume F, Yarmush M, et al. A metabolic index of ischemic injury for perfusion-recovery of cadaveric rat livers. PLoS ONE. 2011;6:e28518 pubmed publisher
    ..The differences between metabolic functions of fresh and ischemic livers during perfusion are outlined and the metabolites that varied significantly for ischemic livers are identified as ornithine, arginine, albumin and tyrosine. ..
  44. Afaneh C, Aull M, Gimenez E, Wang G, Charlton M, Leeser D, et al. Comparison of laparoendoscopic single-site donor nephrectomy and conventional laparoscopic donor nephrectomy: donor and recipient outcomes. Urology. 2011;78:1332-7 pubmed publisher
    ..19, P = .002). No statistically significant differences were found in estimated blood loss, warm ischemia time, length of stay, or visual analog pain scores between the 2 groups...
  45. Lledó García E, Subirá Ríos D, Ogaya Pinies G, Tejedor Jorge A, Cañizo Lopez J, Hernández Fernández C. Intravenous sildenafil as a preconditioning drug against hemodynamic consequences of warm ischemia-reperfusion on the kidney. J Urol. 2011;186:331-3 pubmed publisher
    ..7 mg/kg intravenously 30 minutes before vascular clamping, group 3-sildenafil 0.7 mg/kg intravenously during warm ischemia, group 4-sildenafil 1.4 mg/kg intravenously 30 minutes before vascular clamping and group 5-sildenafil 1...
  46. Monbaliu D, Vekemans K, Hoekstra H, Vaahtera L, Libbrecht L, Derveaux K, et al. Multifactorial biological modulation of warm ischemia reperfusion injury in liver transplantation from non-heart-beating donors eliminates primary nonfunction and reduces bile salt toxicity. Ann Surg. 2009;250:808-17 pubmed publisher
    ..NHBD-LTx, we previously reported a 50% risk of PNF and toxic bile formation in grafts exposed to > or =30' warm ischemia (WI)...
  47. Constantinides C, Tyritzis S, Evangelou C, Kyroudi A, Liatsikos E, Karamessinis P, et al. Vascular endothelial growth factor protein expression in a renal ablation rabbit model under prolonged warm and cold ischemia. Am J Nephrol. 2008;28:438-45 pubmed
    ..VEGF is overexpressed in hypothermic conditions compared to warm ischemia exceeding 60 min. Hypothermia can be more advantageous in a procedure applying prolonged ischemia.
  48. Teoh N, Farrell G. Hepatic ischemia reperfusion injury: pathogenic mechanisms and basis for hepatoprotection. J Gastroenterol Hepatol. 2003;18:891-902 pubmed
    ..A better understanding of preconditioning mechanisms will lead to novel approaches to improve outcomes of liver surgery. ..
  49. Chen F, Nakamura T, Fujinaga T, Zhang J, Hamakawa H, Omasa M, et al. Protective effect of a nebulized beta2-adrenoreceptor agonist in warm ischemic-reperfused rat lungs. Ann Thorac Surg. 2006;82:465-71 pubmed
    ..The control of warm ischemia-reperfusion injury is crucial in manipulating non-beating-heart donors...
  50. Lind M, Hazebroek E, Bajema I, Bonthuis F, Hop W, de Bruin R, et al. Effect of prolonged warm ischemia and pneumoperitoneum on renal function in a rat syngeneic kidney transplantation model. Surg Endosc. 2006;20:1113-8 pubmed
    ..However, graft function may be impaired due to use of pneumoperitoneum and prolonged warm ischemia. This study investigated the impact of pneumoperitoneum and prolonged warm ischemia on long-term graft ..
  51. Orvieto M, Tolhurst S, Chuang M, Lyon M, Ritch C, Rapp D, et al. Defining maximal renal tolerance to warm ischemia in porcine laparoscopic and open surgery model. Urology. 2005;66:1111-5 pubmed
    To establish the upper limit for warm ischemia time (WIT) beyond which irreversible renal failure will occur in a single-kidney porcine model. The maximal renal tolerance during WIT is currently under revision...
  52. Laven B, Orvieto M, Chuang M, Ritch C, Murray P, Harland R, et al. Renal tolerance to prolonged warm ischemia time in a laparoscopic versus open surgery porcine model. J Urol. 2004;172:2471-4 pubmed
    To our knowledge the effects of renal warm ischemia (WI) during laparoscopic vs open surgery have not been investigated. Decreased renal blood flow during pneumoperitoneum may precondition the kidney to tolerate longer WI time...
  53. Orvieto M, Chien G, Laven B, Rapp D, Sokoloff M, Shalhav A. Eliminating knot tying during warm ischemia time for laparoscopic partial nephrectomy. J Urol. 2004;172:2292-5 pubmed
    ..During warm ischemia time (WIT) knot tying is a major time-consuming step...