Using Laser Speckle Contrast Imaging to Quantify Perfusion Quality in Kidney and Pancreas Grafts on Vascular Reperfusion: A Proof-of-Principle Study.

Autor:	Gopal JP; Department of Renal and Pancreas Transplantation, Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United Kingdom.; Department of General Surgery, The Queen Elizabeth Hospital King's Lynn NHS Trust, King's Lynn, United Kingdom., Vaz O; Department of Renal and Pancreas Transplantation, Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United Kingdom.; Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom., Varley R; Department of Renal and Pancreas Transplantation, Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United Kingdom., Spiers H; Department of Transplantation, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.; Department of Surgery, University of Cambridge, Cambridge, United Kingdom., Goldsworthy MA; Department of Renal and Pancreas Transplantation, Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United Kingdom., Siddagangaiah V; Department of Renal and Pancreas Transplantation, Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United Kingdom., Lock B; Moor Instruments Ltd, Axminster, United Kingdom., Sharma V; Department of Renal and Pancreas Transplantation, Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United Kingdom.; Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom., Summers A; Department of Renal and Pancreas Transplantation, Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United Kingdom.; University of Manchester-Faculty of Biology, Medicine and Health, Division of Diabetes, Endocrinology and Gastroenterology, Manchester, United Kingdom., Moinuddin Z; Department of Renal and Pancreas Transplantation, Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United Kingdom.; Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom., van Dellen D; Department of Renal and Pancreas Transplantation, Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United Kingdom.; Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom., Augustine T; Department of Renal and Pancreas Transplantation, Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United Kingdom.; University of Manchester-Faculty of Biology, Medicine and Health, Division of Diabetes, Endocrinology and Gastroenterology, Manchester, United Kingdom.
Jazyk:	angličtina
Zdroj:	Transplantation direct [Transplant Direct] 2023 Apr 19; Vol. 9 (5), pp. e1472. Date of Electronic Publication: 2023 Apr 19 (Print Publication: 2023).
DOI:	10.1097/TXD.0000000000001472
Abstrakt:	The accuracy of intraoperative graft perfusion assessment still remains subjective, with doppler examination being the only objective adjunct. Laser speckle contrast imaging (LSCI) has been used to assess intraoperative blood flow in neurosurgery and in various surgical specialties. Despite its ability to accurately quantify perfusion at the microvascular level, it has not been clinically evaluated in kidney/kidney-pancreas transplantation for perfusion characterization. We aimed to evaluate the utility of LSCI and identify objective parameters that can be quantified at reperfusion. Methods: This study was registered in ClinicalTrials.gov (NCT04202237). The Moor FLPI-2 blood flow imager was used in 4 patients (1 Simultaneous Pancreas and Kidney, 2 deceased, and 1 living donor kidney transplants) during reperfusion to capture reperfusion data. The following parameters were measured: flux (average speed × concentration of moving red blood cells in the sample volume), doppler centroid, total and valid pixels, valid rate, and total and valid area. Flux data were analyzed with Moor FLPI analysis software. Results: The perfusion characteristics and flux images correlated with initial graft function. Conclusions: LSCI is a safe, noncontact imaging modality that provides real-time, accurate, high-resolution, full field blood flow images and a wide range of flux data to objectively quantify organ reperfusion intraoperatively in kidney/kidney-pancreas transplantation. This modality could be used to develop a robust numerical quantification system for the evaluation and reporting of intraoperative organ perfusion, and aid intraoperative decision-making. Perfusion data could be combined with biomarkers and immunological parameters to more accurately predict graft outcomes. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2023 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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