Evidence map›Paper›PMID 40215187›Full record

SynthesisInterdisciplinary cardiovascular and thoracic surgery2025

Kidney protection during surgery on the thoracoabdominal aorta: a systematic review.

James Thomas Bennett, Sarah Shirley, Patricia Murray, Bettina Wilm, Mark Field

Erratum issuedAbstract readSystematic Review
In one paragraph

Synthesis in Interdisciplinary cardiovascular and thoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

James Thomas BennettLiverpool Heart and Chest Hospital NHS Trust, Liverpool, United Kingdom.ORCID 0000-0001-7106-3779
Sarah ShirleyLiverpool Heart and Chest Hospital NHS Trust, Liverpool, United Kingdom.
Patricia MurrayFaculty of Health and Life Sciences, The University of Liverpool, Liverpool, United Kingdom.ORCID 0000-0003-1316-148X
Bettina WilmFaculty of Health and Life Sciences, The University of Liverpool, Liverpool, United Kingdom.ORCID 0000-0002-9245-993X
Mark FieldLiverpool Heart and Chest Hospital NHS Trust, Liverpool, United Kingdom.ORCID 0000-0002-4817-6035

Funding

Liverpool Heart and Chest Hospital NHS Trust
6 · The paper itself

Abstract

objectivesAcute kidney injury (AKI) is a common consequence of surgical repair of the thoraco-abdominal aorta (TAA). Perfusion techniques aim to facilitate renal protection through oxygenation or hypothermia. This systematic review assesses renal and mortality outcomes by perfusion techniques to evaluate their ability to provide effective kidney protection.

methodsPubMed, Web of Science, ClinicalTrials.gov and ClinicalTrialsRegister.EU were searched to identify relevant studies published from 1995 to 2024. Following quality assessment and data extraction, outcomes of the highest quality studies were used to synthesize a narrative discussion.

resultsThirty-eight studies were analysed, featuring three extracorporeal strategies: left heart bypass (LHB; n = 22), cardiopulmonary bypass with deep hypothermic circulatory arrest (DHCA; n = 11) and partial cardiopulmonary bypass (pCPB; n = 10). Three categories of selective renal perfusion (SRP) strategy were identified: warm blood, cold blood and cold crystalloid. Five studies of 'very high' and 'high' quality demonstrate a 0-13.6% incidence of post-operative dialysis and 5.0-13.3% risk of operative mortality following LHB with cold crystalloid SRP. No studies in support of DHCA or pCPB provided a high quality of evidence.

conclusionsLeft heart bypass with crystalloid SRP provides a benchmark for rates of dialysis and mortality following TAA repair. However, AKI remains significant, emphasizing the need for continued innovation in SRP, and a greater understanding of overlooked risk factors. DHCA and pCPB are supported by low-quality evidence, meaning that prospective research is necessary to enable fair comparison. Finally, consensus on data reporting is recommended to improve the quality of future studies in this area.

Indexed as

Acute Kidney InjuryAorta, ThoracicCardiopulmonary BypassCirculatory Arrest, Deep Hypothermia InducedPerfusionVascular Surgical ProceduresHumansRisk FactorsTreatment Outcomeaortakidneyperfusionprotectionrenalthoracoabdominal surgery

Identifiers

PMID40215187
PMCPMC12034379

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.