Correlation of total ischemic time to creatinine serum level and resistive index value in kidney transplant

Abstract

Background: The transient period when the kidney donor was extracted until being anastomosed (total ischemic time) will aggravate many putative molecular ischemic-reperfusion injury mechanisms. Several studies have reported the risk of delayed graft function development, which can be reflected by creatinine serum (Cr) level and resistive index (RI) value. This study aims to determine the correlation of total ischemic time to Cr levels reduction in one-month post-transplantation and RI value.
 Methods: This was a cross-sectional retrospective study involving subjects who underwent kidney transplantation in Sanglah General Hospital. In this study, the primary parameters were total ischemic time, Cr level, and RI value. The total ischemic time is calculated using a stopwatch intraoperatively. Cr level was obtained from blood examination, and RI value was obtained from the ultrasonography test. Data analysis was analyzed statistically using SPSS 24.0, and p < 0.05 was considered significant.
 Results: About 17 kidney transplant subjects were included in this study. The mean total ischemic time was 105 minutes and 43 seconds. There was an insignificant negative correlation between Cr level reduction and total ischemia time (r = -0.36; p = 0.89). An analysis of the correlation of total ischemic time and RI value, there was a linear correlation, but statistically insignificant (r = 0.11; p = 0.66).
 Conclusion: Total ischemic time has a negative correlation with post-transplant creatinine serum level and a positive correlation with the post-transplant resistive index value, but these results are not statistically significant.

Correlation of Prolonged Total Ischemic Time with Body Mass Index in Kidney Transplant: A Single Center Report

“…However, kidney transplantation possesses some complications, one of them is delayed graft function, which is majorly affected by a longer ischemic time during surgery. 2 However, proper functioning of the graft is essential for patients to re-establish body homeostasis so that this transplant can be useful for the patients. The injury during low oxygen and the restoration of oxygen had been proposed to induce ischemia-reperfusion injury (IRI).…”

“…Failure of renal transplant to function immediately with the need for dialysis in the first posttransplantation week define delayed graft function or known as DGF. 2 There are three potential periods of ischemic injury during a kidney graft transplantation surgery as stated by Vinson et al (2018), first is the period before organ retrieval in the donor's body, or know as "first warm ischemia time". The second period occurred when transported donor organ to the recipient in a cold solution, which is defined as cold ischemia time (CIT).…”