Ex-Vivo Perfusion Machines in Kidney Transplantation. The Significance of the Resistivity Index

Elec, Florin Ioan; Lucan, Ciprian; Ghervan, Liviu; Münteanu, Valentin; Moga, Silviu; Suciu, Mihai; D, Enache; Elec, Alina Daciana; Munteanu, Adriana; Barbos, A.; Iacob, G; Lucan, M

doi:10.15386/cjm.2014.8872.871.fie1

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…More than that, the vascular resistivity index measured by Doppler ultrasound is correlated with the resistivity index recorded by the life-port perfusion machine used for kidney preservation. It may predict the primary graft outcome [30]. Seiler et al measured resistivity index in different organs of the transplanted patient, including the renal graft, and concluded that RI indicates the presence of systemic vascular pathology, predicting mortality rather than renal graft dysfunction [31], being affected by pulse pressure, frequency and heart rate [32].…”

Section: B Doppler Vascular Ultrasonographymentioning

confidence: 99%

Current status of imaging diagnosis in the transplanted kidney. A review of the literature with a special focus on contrast-enhanced ultrasonography

Badulescu

Socaciu

Moisoiu

et al. 2020

Medicine and Pharmacy Reports

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Objectives. Ultrasonographic scanning is currently the most widespread imaging diagnostic procedure. The method provides real-time morphological, vascular and elastographic information in a non-invasive manner. In recent years, harmonic vascular examination has become accessible using intravenous contrast agents. In urological pathology, this procedure is used in the detection and evaluation of vascular and ischemic complications, in the classification of complex cysts according to the Bosniak system, also in the renal lesions with uncertain etiology and in acute pyelonephritis for the detection of abscesses. The contrast agent (SonoVue) is angiospecific and can be used in patients transplanted immediately after surgery without adverse effects or impaired renal function. Thus, it is desirable to be used in the nephrological pathology of the renal graft and to develop diagnostic models based on the evaluation of renal microvascularization, as well as the quantitative data resulting from the graphical representation of the specific parameters. The purpose of this review is to evaluate the current state of the literature regarding the place and role of contrast substance ultrasound in the early diagnosis of acute renal graft dysfunction and to make a differential diagnosis of this pathological entity. Method. This review quantifies the role of contrast ultrasound in the diagnosis of acute complications of the renal graft. The research was conducted based on the databases PubMed, MedScape, Cochrane , according to the search criteria such as contrast-enhanced ultrasound + kidney transplant, "time intensity curves" + "kidney transplant”, filtered for the period 2004-2018. Results. In the nephrological pathology of the renal graft, contrast-enhanced ultrasound is a valuable tool, superior to Doppler ultrasound in predicting the evolution of the renal graft, identifying very small early defects in renal microvascularization. A number of studies succeeded in identifying acute graft dysfunction, some of which establish its etiology - humoral rejection versus acute tubular necrosis. On the other hand, the contrast-enhanced ultrasound parameters do not have the ability to distinguish between cellular and humoral rejection. Conclusions. If, at present, the histopathological examination is the only one that can differentiate with certainty the cause of acute renal graft dysfunction, we consider that contrast-enhanced ultrasound, as a non-invasive imaging technique, opens a favorable perspective for increasing the survival of the renal graft and decreasing the complications in the renal transplant. The combination of other ultrasound techniques, together with contrast-enhanced ultrasound, could lead to the development of new diagnostic models.

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Section: B Doppler Vascular Ultrasonographymentioning

confidence: 99%

Current status of imaging diagnosis in the transplanted kidney. A review of the literature with a special focus on contrast-enhanced ultrasonography

Badulescu

Socaciu

Moisoiu

et al. 2020

Medicine and Pharmacy Reports

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Cold ischaemia time: Is too long really too bad? Studies using a porcine kidney ex-vivo reperfusion model

Hamaoui

Gowers

Sandhu

et al. 2020

International Journal of Surgery Open

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Introduction: Post-ischaemic hypothermic machine perfusion (HMP) may be beneficial in recovery of marginal kidney grafts. The full capacity of conventional HMP (with passive oxygenation) to recondition an organ has not been realised. We investigated whether HMP can ameliorate ischemic damage caused by extremely prolonged static cold storage (SCS). Methods: Porcine kidneys underwent 4-h (SCS4,n = 4) or 52-h (SCS52,n = 4) SCS, followed by 10 h of HMP and were then subjected to 2 h of isolated normothermic reperfusion (NRP). Results: There was a post-SCS graft weight loss in SCS52 vs SCS4 kidneys. SCS52 kidneys showed viable perfusion dynamics during HMP, with significantly shorter times to reach viable parameters vs SCS4 kidneys (p < 0.027). During NRP SCS52 kidneys demonstrated similar trends in perfusion dynamics, renal function, oxygen consumptions, lactate production, and tubular injury to SCS4 kidneys. Conclusion: Graft weight loss after SCS, reducing resistance to perfusion, may facilitate better HMP dynamics and graft reconditioning. Clinicians utilising HMP should be aware of this phenomenon when using HMP in kidneys exposed to extreme periods of SCS. HMP after an extended period of SCS can resuscitate kidneys to a level equitable of viability as those after a short period of SCS. Utilising passive oxygenation however may be limiting such recovery and interventions utilising active oxygenation may provide benefit in such organs. Highlights:

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Maximizing kidneys for transplantation using machine perfusion

et al. 2016

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Ex-Vivo Perfusion Machines in Kidney Transplantation. The Significance of the Resistivity Index

Cited by 3 publications

References 8 publications

Current status of imaging diagnosis in the transplanted kidney. A review of the literature with a special focus on contrast-enhanced ultrasonography

Current status of imaging diagnosis in the transplanted kidney. A review of the literature with a special focus on contrast-enhanced ultrasonography

Cold ischaemia time: Is too long really too bad? Studies using a porcine kidney ex-vivo reperfusion model

Maximizing kidneys for transplantation using machine perfusion

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