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Quantitative assessment of microperfusion by indocyanine green angiography in kidney transplantation resembles

Ulrich Rother1, Kerstin Amann2, Werner Adler3

  • 1Department of Vascular Surgery, University of Erlangen, Erlangen, Germany.

Microcirculation (New York, N.Y. : 1994)
|January 19, 2019
PubMed
Abstract

Insights

Indocyanine green (ICG) fluorescence angiography quantifies kidney allograft perfusion, revealing a negative correlation with pre-transplant chronic changes. This method may offer an alternative for assessing microperfusion in kidney transplants.

Area of Science:

  • Nephrology
  • Transplantation Surgery
  • Medical Imaging

Background:

  • Kidney transplantation outcomes depend on allograft perfusion.
  • Assessing microperfusion is crucial for evaluating kidney allograft viability.
  • Pre-existing chronic changes in kidney biopsies can impact transplant success.

Purpose of the Study:

  • To evaluate indocyanine green (ICG) fluorescence angiography for real-time perfusion assessment in kidney transplantation.
  • To correlate intraoperative microperfusion measurements with pre-transplantation chronic kidney disease scores.
  • To compare ICG angiography findings with intrarenal resistance index (RI) from duplex sonography.

Main Methods:

  • Prospective study of 77 end-stage renal disease patients undergoing kidney transplantation across two centers.
  • Correlation analysis between chronic changes in kidney biopsy specimens and the intensity of the ICG fluorescence signal (IN).
  • Calculation of intrarenal resistance index (RI) using duplex sonography as a reference method.

Main Results:

  • A significant negative correlation was observed between ICG signal intensity and the renal chronicity score (r = -0.294, P = 0.017).
  • Significant inverse relationships were found between IN and scores for intestinal fibrosis and tubular atrophy (r = -0.328, P = 0.007).
  • A significant inverse relationship existed between IN and mean RI values in the upper pole of the kidney allograft.

Conclusions:

  • ICG fluorescence angiography effectively reflects pre-existing morphological changes in the renal cortex.
  • ICG angiography serves as a valuable alternative method for assessing kidney allograft microperfusion.
  • This technique provides quantitative, real-time perfusion data crucial for transplantation management.
Keywords:
ICGgraft perfusionkidney specimenkidney transplantation

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