Near‐infrared spectroscopy might be a useful tool for predicting the risk of vascular complications after pediatric liver transplants: Two case reports

Shiba, Juntaro; Satoh, Masaaki; Taira, Koki; Niwa, Yasunori; Inoue, Soichiro; Mizuta, Koichi; Takeuchi, Mamoru

doi:10.1111/petr.13089

Cited by 5 publications

(9 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At the moment, NIRS contributed to the early diagnosis of vascular complications in two children who undergone liver transplantation. 16 However, even if kidney rSrO2 was not altered amongst the patients affected by DGF in the series by Vidal et al, the authors suggested that NIRS might help in discriminating the causes of oligo-anuria in the early post-operative time after KT, helping in managing the postoperative fluid balance. 8 Recently, an experimental study successfully tested a NIRS wireless device implanted on the surface of the kidney.…”

Section: Discussionmentioning

confidence: 95%

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: 95%

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

“…However, Shiba et al described NIRS monitoring in two children encountering vascular complications after liver transplantation. In these cases, decreasing rSO2 values might suggest the occurrence of vascular adverse events 5 …”

Section: Discussionmentioning

confidence: 99%

Can real‐time near‐infrared spectroscopy monitoring detect graft venous thrombosis after pediatric kidney transplantation?

Ghidini

Parolin

Corti

et al. 2021

Pediatric Transplantation

View full text Add to dashboard Cite

Background A prompt detection of graft venous thrombosis might preserve the transplanted organ. A real‐time near‐infrared spectroscopy (NIRS) monitoring of the allograft perfusion could fulfill this goal. The aim of this work was to report the trend of allograft perfusion (rSO2) after pediatric kidney transplantation (KT) complicated by graft venous thrombosis. Case presentation. An infant, affected by end‐stage kidney disease due to posterior urethral valves, underwent non‐living donor KT. The allograft presented both arterial and venous variants and required a complex bench surgery reconstruction. The perfusion of the allograft was monitored by real‐time transcutaneous NIRS. The early post‐operative was conditioned by worsening clinical conditions, and a graft venous thrombosis was detected after four hours since the transplantation. NIRS monitoring lasted for 348 minutes. Median lower pole rSO2‐value was 65% (IQR 62–66%), while the median upper pole rSO2‐value was 70% (IQR 70–71%). These data reflected the congestion of the lower pole, observed at the end of the transplantation. The lower pole showed inferior rSO2 values (p<0.0001). At the end of the monitoring, the decrease in peripheral rSO2, measured in left lower limb as a benchmark, was consistent with the ongoing hypovolemic shock and severe acute anemia. Conclusion Transcutaneous NIRS might be a reliable device for monitoring allograft and peripheric perfusion after pediatric KT. The modifications of rSO2 values helped the clinicians manage the patients in the post‐operative and early detect acute complications.

show abstract

“…Intraoperative tissue oxygenation status may be a composite marker of the balance between oxygen supply and consumption, which is largely determined by hemodynamic perfusion, a venous-weighted mixture of venous and arterial hemoglobin-oxygen saturation, and anesthetic-suppressed or surgical stress-related elevation of the metabolic rate [30]. SstO 2 is an emerging marker of early postoperative complications in patients undergoing LT; however, SstO 2 measurement sites differ among LT studies [9][10][11]. In an intensive care unit study by Civantos et al, the oximetry sensor was placed on the dermatome overlying the liver allograft [9].…”

Section: Plos Onementioning

confidence: 99%

“…SstO 2 was significantly associated with the cardiac index, hemoglobin, and APACHE II score. Shiba et al reported that a reduction in SstO 2 (monitored on the dermatome overlying the liver allograft) was associated with an increased risk of acute graft rejection [10]. Hu et al reported that full drainage of ascites during LT led to an increased leg SstO 2 ; however, IVC clamping and abdominal hypertension caused a significant reduction in the leg SstO 2 .…”

Section: Plos Onementioning

confidence: 99%

See 1 more Smart Citation

Clinical application of intraoperative somatic tissue oxygen saturation for detecting postoperative early kidney dysfunction patients undergoing living donor liver transplantation: A propensity score matching analysis

Park

Jung

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

Background Somatic tissue oxygen saturation (SstO2) is associated with systemic hypoperfusion. Kidney dysfunction may lead to increased mortality and morbidity in patients who undergo living donor liver transplantation (LDLT). We investigated the clinical utility of SstO2 during LDLT for identifying postoperative kidney dysfunction. Patients and methods Data from 304 adults undergoing elective LDLT between January 2015 and February 2020 at Seoul St. Mary’s Hospital were retrospectively collected. Thirty-six patients were excluded based on the exclusion criteria. In total, 268 adults were analyzed, and 200 patients were 1:1 propensity score (PS)-matched. Results Patients with early kidney dysfunction had significantly lower intraoperative SstO2 values than those with normal kidney function. Low SstO2 (< 66%) 1 h after graft reperfusion was more highly predictive of early kidney dysfunction than the values measured in other intraoperative phases. A decline in the SstO2 was also related to kidney dysfunction. Conclusions Kidney dysfunction after LDLT is associated with patient morbidity and mortality. Our results may assist in the detection of early kidney dysfunction by providing a basis for analyzing SstO2 in patients undergoing LDLT. A low SstO2 (< 66%), particularly 1 h after graft reperfusion, was significantly associated with early kidney dysfunction after surgery. SstO2 monitoring may facilitate the identification of early kidney dysfunction and enable early management of patients.

show abstract

Near‐infrared spectroscopy might be a useful tool for predicting the risk of vascular complications after pediatric liver transplants: Two case reports

Cited by 5 publications

References 11 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

Can real‐time near‐infrared spectroscopy monitoring detect graft venous thrombosis after pediatric kidney transplantation?

Clinical application of intraoperative somatic tissue oxygen saturation for detecting postoperative early kidney dysfunction patients undergoing living donor liver transplantation: A propensity score matching analysis

Contact Info

Product

Resources

About