| Autor: |
Lau H; Division of Transplantation, Department of Surgery, University of California, Irvine, CA 92868, USA., Lopez AJ; Division of Transplantation, Department of Surgery, University of California, Irvine, CA 92868, USA., Eguchi N; Division of Transplantation, Department of Surgery, University of California, Irvine, CA 92868, USA., Shimomura A; Division of Transplantation, Department of Surgery, University of California, Irvine, CA 92868, USA., Ferrey A; Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California, Irvine, CA 92868, USA., Tantisattamo E; Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California, Irvine, CA 92868, USA., Reddy U; Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California, Irvine, CA 92868, USA., Dafoe D; Division of Transplantation, Department of Surgery, University of California, Irvine, CA 92868, USA., Ichii H; Division of Transplantation, Department of Surgery, University of California, Irvine, CA 92868, USA. |
| Abstrakt: |
Conventional renal function markers are unable to measure renal allograft perfusion intraoperatively, leading to delayed recognition of initial allograft function. A handheld near-infrared spectroscopy (NIRS) device that can provide real-time assessment of renal allograft perfusion by quantifying regional tissue oxygen saturation levels (rSO 2 ) was approved by the FDA. This pilot study evaluated the feasibility of intraoperative NIRS monitoring of allograft reperfusion in renal transplant recipients (RTR). Intraoperative renal allograft rSO 2 and perfusion rates were measured in living (LDRT, n = 3) and deceased donor RTR (DDRT, n = 4) during the first 50 min post-reperfusion and correlated with renal function markers 30 days post-transplantation. Intraoperative renal allograft rSO 2 for the DDRT group remained significantly lower than the LDRT group throughout the 50 min. Reperfusion rates were significantly faster in the LDRT group during the first 5 min post-reperfusion but remained stable thereafter in both groups. Intraoperative rSO 2 were similar among the upper pole, renal hilum, and lower pole, and strongly correlated with allograft function and hemodynamic parameters up to 14 days post-transplantation. NIRS successfully detected differences in intraoperative renal allograft rSO 2 , warranting future studies to evaluate it as an objective method to measure ischemic injury and perfusion for the optimization of preservation/reperfusion protocols and early prediction of allograft function. |
