Advances in Hypothermic and Normothermic Perfusion in Kidney Transplantation

Smith, Thomas B.; Nicholson, Michael L.; Hosgood, Sarah A.

doi:10.3390/transplantology2040044

Cited by 6 publications

(5 citation statements)

References 102 publications

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“…This difference may indicate impaired cortical kidney perfusion, stemming from damaged capillaries and decreased renal filtration in damaged kidney allografts. A previous study ( 25 ) showed that cortical perfusion was lower in renal allograft recipients with low eGFR, while 2-4 weeks after transplantation.…”

Section: Discussionmentioning

confidence: 97%

A clinical study of using ROC to compare the efficiency of ASL and BOLD in diagnosis of renal allograft function

Jin¹,

Yang²,

Zhu³

et al. 2023

Transl Androl Urol

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Background: This retrospective study aims to evaluate the effectiveness of renal transplantation function by comparing arterial spin labeling (ASL) and blood oxygen level dependent (BOLD) imaging with the receiver operating characteristic (ROC) curve.Methods: According to the estimated glomerular filtration rate (eGFR) values, 42 patients with normal kidney grafts (the normal kidney graft group, eGFR <60 mL/min/1.73 m 2 ) and 93 patients with injured grafts (the kidney graft injury group, eGFR <60 mL/min/1.73 m 2 ) were included in the present study. Renal blood flow (RBF) and the effective transverse relaxation rate (R2*) were calculated by comparing ASL and BOLD imaging. The ROC curve and the youden index were used to evaluate the diagnostic performance of ASL, BOLD, and the combination of them. Results:The results showed that all the clinical features of the patients, except for gender, differed significantly between the 2 groups (P<0.05). The mean RBF value of the renal transplant injury group (104.33±54.76 mL/100 g/min) was significantly lower than that of the normal group (191.84±63.96 mL/ 100 g/min, P<0.01). The mean medullary R2* value of the renal transplant injury group (27.91±3.35 1/s) was significantly higher than that of the normal group (25.22±2.94 1/s, P<0.01). Negative correlations were found between R2* and eGFR (r=-0.44), and RBF and R2* (r=-0.54; both P<0.01). The ROC analysis showed that both RBF and R2* reflected injured renal function [area under the curves (AUC) =0.86 and 0.72, respectively]. In addition, the AUC of RBF and R2* combined was 0.86, which was comparable to that of RBF alone (P=0.95), while combining R2* and RBF improved the diagnostic performance of R2* alone (AUC =0.86 versus 0.72, respectively; P<0.01). The youden index analysis showed that the diagnostic accuracy of ASL was 80.00%, better than 71.85% of BOLD; the sensitivity and specificity of ASL in diagnosing renal allograft dysfunction were 79.57% and 80.95%, superior to 77.42% and 59.52% of BOLD.Conclusions: Our results showed that the non-invasive assessment of ASL in clinical kidney transplant function is a more promising imaging technique than BOLD.

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Section: Discussionmentioning

confidence: 97%

A clinical study of using ROC to compare the efficiency of ASL and BOLD in diagnosis of renal allograft function

Jin¹,

Yang²,

Zhu³

et al. 2023

Transl Androl Urol

View full text Add to dashboard Cite

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“…It is difficult to compare these machines and the published results because they differ in terms of the temperature used, oxygen and nutrient supply, duration of perfusion, and technical details such as pulsatile or non-pulsatile perfusion, automation and monitoring. No scientific trials have directly compared the use and efficacy of one apparatus to that of another [ 27 - 31 ].…”

Section: Kidney Preservationmentioning

confidence: 99%

Cold but not too cold: advances in hypothermic and normothermic organ perfusion

Kirste

2022

Korean J Transplant

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Transplantation is the method of choice and, in many cases, the only method of treatment for patients with end-stage organ disease. Excellent results have been achieved, and the main focus today is to extend the number of available donors. The use of extended-criteria donors or donors after circulatory death is standard, but is accompanied by an increased risk of ischemia reperfusion injury. This review presents newly developed machine perfusion techniques using hypothermic, subnormothermic, or normothermic conditions, with or without oxygenation. Possibilities for treatment and quality assessment in decision-making about organ acceptability are also discussed.

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“…That is why new perfusion technologies are being considered. Developments in hypothermic (HMP) and normothermic machine perfusion (NMP) technologies have shown potential in clinical kidney transplantation [18]. HMP involves the use of a mechanical pump to circulate cold preservation fluid in the graft, while during NMP, the graft is perfused at near-physiological temperatures and pressures, allowing cellular metabolism and function to be restored.…”

Section: Figurementioning

confidence: 99%

"Let's Live Life - Let's Give Life”: Donor Program Improvement as the Key to Transplantation Success in 21<sup>st</sup> Century - A Croatian Experience

Brusich¹

2022

OBM Transplant

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Transplantation is a widely accepted and successful life-saving treatment for hundreds of thousands of patients. However, transplant medicine still faces a number of obstacles. One of the most significant is the large disparity between the number of donors and recipients and the growing need for re-transplantation. In the last two decades, the improvement and organization of the national transplantation program in Croatia have resulted in a steadily increasing donor rate and therefore the transplantation numbers. As the key points of the donor program's success, I would single out the appointment of hospital and national transplant coordinators, the financial reimbursement model for additional medical staff engaged with the donors, the adoption of new legislation, public awareness campaigns and international cooperation with Eurotransplant.

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Advances in Hypothermic and Normothermic Perfusion in Kidney Transplantation

Cited by 6 publications

References 102 publications

A clinical study of using ROC to compare the efficiency of ASL and BOLD in diagnosis of renal allograft function

A clinical study of using ROC to compare the efficiency of ASL and BOLD in diagnosis of renal allograft function

Cold but not too cold: advances in hypothermic and normothermic organ perfusion

"Let's Live Life - Let's Give Life”: Donor Program Improvement as the Key to Transplantation Success in 21<sup>st</sup> Century - A Croatian Experience

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