Indocyanine Green Angiography for Quality Assessment of the Kidney During Transplantation: An Outcome Predictor Prospective Study

被引：5

作者：

Ietto, Giuseppe ^{[1
,2
]}

Zani, Elia ^{[1
,2
]}

Benedetti, Fabio ^{[2
]}

Parise, Cristiano ^{[1
,2
]}

Iori, Valentina ^{[1
,2
]}

Masci, Federica ^{[1
,2
]}

Franchi, Caterina ^{[1
,2
]}

Ferri, Enrico ^{[3
]}

Liepa, Linda ^{[1
,2
]}

Brusa, Davide ^{[2
]}

Oltolina, Mauro ^{[1
,2
]}

Baglieri, Cristiano ^{[2
]}

Ripamonti, Marta ^{[1
,2
]}

Guzzetti, Luca ^{[2
,4
]}

Dalla Gasperina, Daniela ^{[2
,5
]}

Ambrosini, Andrea ^{[2
,6
]}

Amico, Francesco ^{[7
]}

Di Saverio, Salomone ^{[1
,2
]}

Latham, Lorenzo ^{[1
,2
]}

Iovino, Domenico ^{[1
,2
]}

Soldini, Gabriele ^{[1
,2
]}

Tozzi, Matteo ^{[2
,8
]}

Carcano, Giulio ^{[1
,2
]}

机构：

[1] ASST Settelaghi, Gen Emergency & Transplant Surg Dept, Varese, Italy

[2] Univ Insubria, Varese, Italy

[3] Univ Insubria, Gen Emergency & Transplant Surg Dept, Via Pietro Verri 12, Varese, Italy

[4] ASST Settelaghi, Anesthesia & Intens Care Unit, Varese, Italy

[5] ASST Settelaghi, Infect Dis Dept, Varese, Italy

[6] ASST Settelaghi, Nephrol Dept, Varese, Italy

[7] Univ Newcastle, Dept Surg, Trauma Serv, Newcastle, NSW, Australia

[8] ASST Settelaghi, Vasc Surg Dept, Varese, Italy

来源：

TRANSPLANTATION PROCEEDINGS | 2021年 / 53卷 / 06期

关键词：

DELAYED GRAFT FUNCTION; FLUORESCENCE; LAPAROSCOPY; RECIPIENTS; DIAGNOSIS; PERFUSION; LIGHT;

D O I：

10.1016/j.transproceed.2021.06.010

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. Microvascular damage is the main cause of delayed graft function (DGF) after kidney transplant. Assessing its extent may be helpful in predicting DGF to achieve better postoperative management, especially in terms of an immunosuppressive regimen. Our aim was to explore the capability of intraoperative indocyanine green (ICG) angiography to examine the microvasculature of the kidney. Methods. We conducted a prospective cohort study on 37 kidney transplant recipients in a high-volume kidney transplant center. During surgery, after graft implant, an ICG angiography was performed through a high-definition Storz camera system (Karl Storz GmbH, Tuttlingen, Germany) with successive quantitative assessment of fluorescence using Icy bioimage analysis. Results. All transplanted kidneys that showed immediate recovery of their function had a fluorescent intensity >= 49.953 with a mean of 96.930 +/- 21. The fluorescence intensity for kidneys that showed a delayed recovery of their function never exceeded 55.648, and the mean was 37.718 +/- 13. The difference between the 2 groups was statistically significant with a P value < .001. The only kidney that never recovered showed a fluorescence intensity consistently <25.220, the lowest detected. Conclusions. This study demonstrates that intraoperative ICG angiography may be used to assess the microvasculature of the graft. A statistically significant difference in terms of fluorescent intensity can be highlighted between kidneys that immediately recover their function and those with delayed recovery. Further larger studies are needed to confirm the capability of the technique to predict DGF to optimize the transplanted patients' management.

引用

页码：1892 / 1896

页数：5

共 32 条

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