医学
灌注
机器灌注
肾
肾移植
高光谱成像
缺血
移植
泌尿科
吻合
薄壁组织
核医学
病理
外科
放射科
心脏病学
内科学
肝移植
地质学
遥感
作者
Robert Sucher,Tristan Wagner,Helmut Köhler,Elisabeth Sucher,Hanna Guice,Sebastian Recknagel,Andri Lederer,Hans Michael Hau,Sebastian Rademacher,Stefan Schneeberger,Gerald Brandacher,Ines Gockel,Daniel Seehofer
出处
期刊:Annals of Surgery
[Ovid Technologies (Wolters Kluwer)]
日期:2020-11-13
卷期号:276 (1): e48-e55
被引量:22
标识
DOI:10.1097/sla.0000000000004429
摘要
Objective: Aim of our study was to test a noninvasive HSI technique as an intraoperative real time assessment tool for deceased donor kidney quality and function in human kidney allotransplantation. Summary of Background Data: HSI is capable to deliver quantitative diagnostic information about tissue pathology, morphology, and composition, based on the spectral characteristics of the investigated tissue. Because tools for objective intraoperative graft viability and performance assessment are lacking, we applied this novel technique to human kidney transplantation. Methods: Hyperspectral images of distinct components of kidney allografts (parenchyma, ureter) were acquired 15 and 45 minutes after reperfusion and subsequently analyzed using specialized HSI acquisition software capable to compute oxygen saturation levels (StO 2 ), near infrared perfusion indices (NIR), organ hemoglobin indices, and tissue water indices of explored tissues. Results: Seventeen kidney transplants were analyzed. Median recipient and donor age were 55 years. Cold ischemia time was 10.8 ± 4.1 hours and anastomosis time was 35 ± 7 minutes (mean ± standard deviation). Two patients (11.8%) developed delayed graft function (DGF). cold ischemia time was significantly longer (18.6 ± 1.6) in patients with DGF (P < 0.01). Kidneys with DGF furthermore displayed significant lower StO 2 (P = 0.02) and NIR perfusion indices, 15 minutes after reperfusion (P < 0.01). Transplant ureters displayed a significant decrease of NIR perfusion with increased distance to the renal pelvis, identifying well and poor perfused segments. Conclusion: Intraoperative HSI is feasible and meaningful to predict DGF in renal allografts. Furthermore, it can be utilized for image guided surgery, providing information about tissue oxygenation, perfusion, hemoglobin concentration, and water concentration, hence allowing intraoperative viability assessment of the kidney parenchyma and the ureter.
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