Near real-time estimation of blood loss and flow-pressure re-distribution during unilateral nephrectomy

Cowley, James and Kyeremeh, Justicia and Stewart, Grant D. and Luo, Xichun and Shu, Wenmiao and Kazakidi, Asimina (2024) Near real-time estimation of blood loss and flow-pressure re-distribution during unilateral nephrectomy. Fluids, 9 (9). 214. ISSN 2311-5521 (https://doi.org/10.3390/fluids9090214)

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Abstract

Radical or partial nephrectomy, commonly used for the treatment of kidney tumors, is a surgical procedure with a risk of high blood loss. The primary aim of this study is to quantify blood loss and elucidate the redistribution of blood flux and pressure between the two kidneys and the abdominal aorta during renal resection. We have developed a robust research methodology that introduces a new lumped-parameter mathematical model, specifically focusing on the vasculature of both kidneys using a non-Newtonian Carreau fluid. This model, a first-order approximation, ac-counts for the variation in the total impedance of the vasculature when various vessels are severed in the diseased kidney (assumed to be the left in this work). The model offers near real-time estima-tions of the flow-pressure redistribution within the vascular network of the two kidneys and the downstream aorta for several radical or partial nephrectomy scenarios. Notably, our findings indi-cate that the downstream aorta receives approximately 1.27 times higher percentage of the redis-tributed flow from the diseased kidney compared to the healthy kidney, in nearly all examined cases. The implications of this study are significant, as they can inform the development of surgical protocols required to minimize blood loss and assist surgeons in evaluating the adequacy of the remaining kidney vasculature to support the organ.

ORCID iDs

Cowley, James ORCID logoORCID: https://orcid.org/0000-0002-0161-355X, Kyeremeh, Justicia, Stewart, Grant D., Luo, Xichun ORCID logoORCID: https://orcid.org/0000-0002-5024-7058, Shu, Wenmiao ORCID logoORCID: https://orcid.org/0000-0002-1220-361X and Kazakidi, Asimina ORCID logoORCID: https://orcid.org/0000-0001-7124-4123;
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