Utility of Basal Regional Oximetry Saturation for the Diagnosis of Acute Tubular Necrosis in the Early Postoperative Period Following Kidney Transplantation

Civantos, Demetrio Víctor Pérez; Cantero, Alicia Muñoz; Marcos, Miguel; Fariñas, Humberto; Triviño, Marcello; Frutos, María Dolores; Torres, Bertha

doi:10.1016/j.transproceed.2018.12.011

Cited by 7 publications

(6 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, Pérez Civantos et al assessed renal rSrO2 in 61 adults who undergone KT, using probes with a maximum depth of 2.5 cm 14 . NIRS readings were significantly correlated with the decreasing values of serum lactate for 8 hours and 24 hours, which is another marker of ischemic injury.…”

Section: Discussionmentioning

confidence: 99%

Transcutaneous near‐infrared spectroscopy (NIRS) for monitoring kidney and liver allograft perfusion

Ghidini

Benetti

Zucchetta

et al. 2021

Int. J. Clin. Pract.

View full text Add to dashboard Cite

Kidney transplantation (KT) has become the treatment of choice for paediatric end-stage kidney disease. 1 Nevertheless, in comparison to adults, the small calibre of the vessels and the common size-mismatch between donors and recipients can predispose to vascular complications including allograft thrombosis. The latter may affect up to 10% of KTs and account for 35% of allograft losses in the first year. 2 Similar considerations might be made when dealing with liver transplantation (LT). Even in this case, early vascular complications may affect up to 25% of the grafts. 3 Therefore, prompt recognition and treatment are clearly essential for the preservation of the allograft.Vascular complications have no specific clinical or biochemical signs allowing for early diagnosis. Doppler-ultrasonography (DUS) and scintigraphy, for KT, are reliable tools to assess allograft perfusion, 4 but do not allow continuous monitoring of the allograft and can miss early diagnosis, even if performed with a strict schedule in early follow-up. 5 Transcutaneous near-infrared spectroscopy (NIRS) allows for non-invasive, real-time, continuous monitoring of regional oxygenation of the hemoglobin (rSrO2), which is an indirect measure of the blood flow and the metabolic state, of tissue placed deeper beyond the skin. Several clinical studies have tested the use of NIRS for monitoring cerebral and somatic perfusion in intensive care units 6 and

show abstract

Section: Discussionmentioning

confidence: 99%

Transcutaneous near‐infrared spectroscopy (NIRS) for monitoring kidney and liver allograft perfusion

Ghidini

Benetti

Zucchetta

et al. 2021

Int. J. Clin. Pract.

View full text Add to dashboard Cite

show abstract

“…Experimentally, NIRS has been used to monitor organ perfusion (even non-parenchymatous) [21] and even considered in post-transplant graft monitoring [22]. In human transplantation medicine, NIRS has been used in pediatric post-transplant monitoring, but only as a non-invasive method [6][7][8]. That can only be considered in children and adults with slim builds.…”

Section: Discussionmentioning

confidence: 99%

“…It would be of great benefit if graft blood perfusion could be monitored continuously during the early postoperative period. In literature, two approaches are recommended when continuously monitoring kidney graft perfusion: measuring of electromagnetic waves with nearinfrared spectroscopy (NIRS) [6][7][8] and monitoring mechanical waves through Doppler ultrasound (DUS) [9,10].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

NIRS-based monitoring of kidney graft perfusion

et al. 2020

View full text Add to dashboard Cite

Introduction Acute early vascular complications are rare, but serious complications after kidney transplantation. They often result in graft loss. For this reason, shortening the diagnostic process is crucial. Currently, it is standard procedure to monitor renal graft perfusion using Doppler ultrasound (DU). With respect to acute vascular complications, the main disadvantage of this type of examination is its periodicity. It would be of great benefit if graft blood perfusion could be monitored continuously during the early postoperative period. It appears evident that a well-designed near infrared spectroscopy (NIRS) monitoring system could prove very useful during the early post-transplantation period. Its role in the immediate diagnosis of vascular complications could result in a significant increase in graft salvage, thus improving the patient’s overall quality of life and lowering morbidity and mortality for renal graft recipients. The aim of this study was to design, construct and test such a monitoring system. Materials and methods We designed a rough NIRS-based system prototype and prepared a two-stage laboratory experiment based on a laboratory pig model. In the first stage, a total of 10 animals were used to verify and optimize the technical aspects and functionality of the prototype sensor by testing it on the animal kidneys in-vivo. As a result of these tests, a more specific prototype was designed. During the second stage, we prepared a unique laboratory model of a pig kidney autotransplantation and tested the system for long-term functionality on a group of 20 animals. Overall sensitivity and specificity were calculated, and a final prototype was prepared and completed with its own analytic software and chassis. Results We designed and constructed a NIRS-based system for kidney graft perfusion monitoring. The measurement system provided reliable performance and 100% sensitivity when detecting acute diminished blood perfusion of the transplanted kidneys in laboratory conditions. Conclusion The system appears to be a useful tool for diagnosing diminished blood perfusion of kidney transplants during the early postoperative period. However, further testing is still required. We believe that applying our method in current human transplantation medicine is feasible, and we are confident that our prototype is ready for human testing.

show abstract

“…Evidence shows that ATN is the most common cause of graft failure for up to 50% of transplanted kidneys following the use of cyclosporine (21,22). Hypoperfusion, cold ischemia times, harvesting, anastomosis, surgical approach and the administration of cyclosporine following renal transplantation are revealed by now about the etiologic causes of ATN (23,24). Oliguria caused by ATN lasts for two months.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the relationship between acute tubular necrosis and kidney transplantation

et al. 2020

View full text Add to dashboard Cite

Introduction: Acute tubular necrosis (ATN) is a common syndrome following kidney transplantation. In this study, we reviewed systematically the relationship between ATN and kidney transplantation. Materials and Methods: International databases including PubMed, Web of Science and Scopus were considered for search of English articles by Aug 2019. Seven published articles were finally entered into the study. Keywords were ATN, acute kidney injury, kidney transplantation and renal transplantation or a combination of them in the title/abstracts. Results: There were seven published articles (conducted on 2,534 individuals) reviewed in this systematic review consisted of two retrospective, three prospective studies and two clinical trial studies. Conclusion: The administration of cyclosporine immediately following kidney transplantation is a predicting factor for development of ATN. According to the results, ATN can be associated with kidney transplantation, especially transplanted from deceased donors.

show abstract

Utility of Basal Regional Oximetry Saturation for the Diagnosis of Acute Tubular Necrosis in the Early Postoperative Period Following Kidney Transplantation

Cited by 7 publications

References 15 publications

Transcutaneous near‐infrared spectroscopy (NIRS) for monitoring kidney and liver allograft perfusion

Transcutaneous near‐infrared spectroscopy (NIRS) for monitoring kidney and liver allograft perfusion

NIRS-based monitoring of kidney graft perfusion

A systematic review of the relationship between acute tubular necrosis and kidney transplantation

Contact Info

Product

Resources

About