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High-Resolution Imaging Using the VisualSonics Vevo 2100 on Isolated, Perfused Porcine Kidneys on Mechanical
Paul L Linsky1, Young Choi, Rosemary Ouseph
1From the *Hiram C. Polk, Jr. Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky; †Cardiovascular Innovation Institute, University of Louisville, Louisville, Kentucky; ‡Speed School of Engineering, University of Louisville, Louisville, Kentucky; §Division of Nephrology, Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky; and ¶Division of Pediatric Cardiology, Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky.
Abstract:
Despite many improvements in the field of renal transplantation, the key problem that persists is the lack of organs for all the patients who need kidneys. This problem continues despite the addition of extended criteria donors and donation after cardiac death. Compounding this issue is the high discard rate and there are no good means to truly predict renal function using current pretransplantation testing parameters. In an isolated renal perfusion model using porcine kidneys, we tested the proof of principle that a Vevo 2100 high-frequency high-resolution ultrasound system (Fujifilm VisualSonics, Inc., Toronto, Canada) could assess renal parenchymal perfusion and flow in the central renal vessels which could not assess by conventional ultrasound. Images and velocities were easily obtained during these studies. High-frequency ultrasound imaging may be a feasible and reproducible method for assessing renal parenchymal integrity and function pretransplantation. Further studies are required to determine the sensitivity and specificity of this approach in comparison with traditional renal biopsy pretransplantation with the goal of increasing the identification and use of donated kidneys for transplantation.
Insights
High-frequency ultrasound shows promise for assessing kidney function before transplantation. This technology could help increase the use of donated kidneys by improving pretransplantation evaluation.
Area of Science:
- Nephrology
- Transplantation Medicine
- Medical Imaging
Background:
- The critical shortage of donor kidneys for transplantation persists despite advancements.
- High discard rates and inadequate pretransplantation assessment of renal function contribute to organ scarcity.
Purpose of the Study:
- To evaluate the feasibility of high-frequency ultrasound for assessing renal parenchymal perfusion and central renal vessel flow.
- To determine if high-frequency ultrasound can improve pretransplantation evaluation of donated kidneys.
Main Methods:
- Utilized an isolated renal perfusion model with porcine kidneys.
- Employed a Vevo 2100 high-frequency high-resolution ultrasound system to image renal vasculature and assess flow.
Main Results:
- High-frequency ultrasound successfully obtained clear images and velocity data of renal parenchymal perfusion and central renal vessels.
- The technology demonstrated potential for assessing renal integrity and function in a preclinical setting.
Conclusions:
- High-frequency ultrasound imaging presents a feasible and reproducible method for evaluating renal parenchymal integrity and function pretransplantation.
- Further research is needed to establish the sensitivity and specificity of this technique compared to renal biopsy for optimizing donor kidney utilization.
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