TY - JOUR
T1 - Predictive Value of Intraoperative Doppler Flowmetry for Delayed Graft Function in Kidney Transplantation
T2 - A Pilot Study
AU - Pravisani, Riccardo
AU - Baccarani, Umberto
AU - Langiano, Nicola
AU - Meroi, Francesco
AU - Avital, Itzhak
AU - Bove, Tiziana
AU - Adani, Gian Luigi
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - Background: The delayed graft function (DGF) in kidney transplantation (KT) is a risk factor for long-term poor graft survival. The pathogenesis is multifactorial but mainly related to an ischemia-reperfusion injury. However, the graft hemodynamics have been recently identified as a key aspect for early DGF risk assessment and potential therapeutic intervention. Methods: A pilot study on 20 single kidney grafts from donor after brain death with intraoperative measurement of graft arterial flowmetry, 30 minutes after reperfusion. Exclusion criteria were grafts with multiple arteries or severe atherosclerosis of the recipient's external iliac artery. Results: KT recipients with DGF (n = 4, 20%) were homogenous with controls (n = 16) in terms of cold ischemia time, donor age, recipients' hemodynamic parameters, renal artery, and recipients' external iliac artery diameters. Nonetheless, at transplant, the kidney grafts that developed DGF were characterized by a significantly higher renal artery resistive index (DGF vs no-DGF 0.96 ± 0.04 vs 0.77 ± 0.13, P =.02), as well as lower flow extraction rate (24.8% ± 11.8 vs 59.2% ± 21.1, P <.01).
AB - Background: The delayed graft function (DGF) in kidney transplantation (KT) is a risk factor for long-term poor graft survival. The pathogenesis is multifactorial but mainly related to an ischemia-reperfusion injury. However, the graft hemodynamics have been recently identified as a key aspect for early DGF risk assessment and potential therapeutic intervention. Methods: A pilot study on 20 single kidney grafts from donor after brain death with intraoperative measurement of graft arterial flowmetry, 30 minutes after reperfusion. Exclusion criteria were grafts with multiple arteries or severe atherosclerosis of the recipient's external iliac artery. Results: KT recipients with DGF (n = 4, 20%) were homogenous with controls (n = 16) in terms of cold ischemia time, donor age, recipients' hemodynamic parameters, renal artery, and recipients' external iliac artery diameters. Nonetheless, at transplant, the kidney grafts that developed DGF were characterized by a significantly higher renal artery resistive index (DGF vs no-DGF 0.96 ± 0.04 vs 0.77 ± 0.13, P =.02), as well as lower flow extraction rate (24.8% ± 11.8 vs 59.2% ± 21.1, P <.01).
UR - http://www.scopus.com/inward/record.url?scp=85082518724&partnerID=8YFLogxK
U2 - 10.1016/j.transproceed.2020.02.049
DO - 10.1016/j.transproceed.2020.02.049
M3 - Article
C2 - 32229046
AN - SCOPUS:85082518724
SN - 0041-1345
VL - 52
SP - 1556
EP - 1558
JO - Transplantation Proceedings
JF - Transplantation Proceedings
IS - 5
ER -