Modified spectrometry (O2C device) of intraoperative microperfusion predicts organ function after kidney transplantation: a pilot study

Transplant Proc. 2009 Nov;41(9):3575-9. doi: 10.1016/j.transproceed.2009.06.234.

Abstract

Background: Delayed graft function (DGF) is defined as posttransplantation dialysis within 1 week, which might be associated with impaired long-term graft survival. The aim of our pilot study was to establish the ability of intraoperative spectrometry of allograft microperfusion to predict DGF.

Methods: Twenty human kidney allografts transplanted from deceased donors were evaluated intraoperatively after reperfusion using modified organ spectrometry (O2C device). We examined hemoglobin oxygen saturation, intravascular amount of hemoglobin, and microperfusion flow/velocity.

Results: Retrospectively, 10/20 (50%) allografts with measurable impairment of cortical hemoglobin oxygen saturation and microperfusion flow/velocity developed DGF. Retrospectively, we found that if the intravascular amount of hemoglobin was increased upon intraoperative measurement, the kidney was prone to develop DGF.

Conclusions: Spectrometry data predicted DGF. Our results supported the thesis that impaired microperfusion is the key to DGF and might be related to postcapillary endothelial damage or intravascular sludge.

MeSH terms

  • Adult
  • Blood Pressure
  • Cadaver
  • Graft Rejection / epidemiology
  • Hematoma / etiology
  • Hematoma / therapy
  • Hepatic Artery / surgery
  • Hepatic Veins / surgery
  • Humans
  • Kidney Transplantation / methods*
  • Kidney Transplantation / physiology*
  • Middle Aged
  • Monitoring, Intraoperative / instrumentation
  • Monitoring, Intraoperative / methods
  • Perfusion
  • Postoperative Complications / epidemiology
  • Predictive Value of Tests
  • Retrospective Studies
  • Stents
  • Tissue Donors
  • Transplantation, Homologous / methods
  • Ureter / transplantation
  • Urinary Bladder / surgery