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

Angiography Delayed Graft Function Humans Indocyanine Green Kidney Kidney Transplantation Prospective Studies

Journal

Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532

Informations de publication

Date de publication:
Historique:
received: 08 03 2021
revised: 05 05 2021
accepted: 01 06 2021
pubmed: 9 7 2021
medline: 21 10 2021
entrez: 8 7 2021
Statut: ppublish

Résumé

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. 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. 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. 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.

Sections du résumé

BACKGROUND 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 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 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 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.

Identifiants

DOI: 10.1016/j.transproceed.2021.06.010 PMID: 34233847
pubmed: 34233847
pii: S0041-1345(21)00422-X
doi: 10.1016/j.transproceed.2021.06.010
pii:
doi:

Substances chimiques

Indocyanine Green IX6J1063HV

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1892-1896

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Auteurs

Giuseppe Ietto (G)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy. Electronic address: giuseppe.ietto@gmail.com.

Elia Zani (E)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Fabio Benedetti (F)

University of Insubria, Varese, Italy.

Cristiano Parise (C)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Valentina Iori (V)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Federica Masci (F)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Caterina Franchi (C)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Enrico Ferri (E)

General, Emergency and Transplant Surgery Department, University of Insubria, Varese, Italy.

Linda Liepa (L)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Davide Brusa (D)

University of Insubria, Varese, Italy.

Mauro Oltolina (M)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Cristiano Baglieri (C)

University of Insubria, Varese, Italy.

Marta Ripamonti (M)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Luca Guzzetti (L)

Anesthesia and Intensive Care Unit, ASST-Settelaghi and University of Insubria, Varese, Italy.

Daniela Dalla Gasperina (D)

Infectious Disease Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Andrea Ambrosini (A)

Nephrology Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Francesco Amico (F)

Trauma Service, Department of Surgery, University of Newcastle, Newcastle, Australia.

Salomone Di Saverio (S)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Lorenzo Latham (L)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Domenico Iovino (D)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Gabriele Soldini (G)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Matteo Tozzi (M)

Vascular Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Giulio Carcano (G)

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

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Classifications MeSH

questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Techniques de diagnostic cardiovasculaire › Angiographie › Indocyanine Green Angiography for Quality...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Reprise retardée de fonction du greffon › Indocyanine Green Angiography for Quality...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Indocyanine Green Angiography for Quality...
questionsmedicales.fr › Composés hétérocycliques › Composés hétérocycliques à cycles fusionnés › Composés hétérobicycliques › Indoles › Vert indocyanine › Indocyanine Green Angiography for Quality...
questionsmedicales.fr › Appareil urogénital › Voies urinaires › Rein › Indocyanine Green Angiography for Quality...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie urogénitale › Procédures de chirurgie urologique › Transplantation rénale › Indocyanine Green Angiography for Quality...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Indocyanine Green Angiography for Quality...