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Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation
Published on: July 15, 2015
[Features of nephrotransplant blood flow during kidney transplant]
S S Dunaevskaya1,2, A A Kosik1,2, M F Kuchkarov1,2
1Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Introduction:
Kidney transplantation, which provides a high quality of life for patients with terminal chronic renal failure worldwide, is recognized as one of the main achievements of modern medicine. Graft dysfunction is an urgent problem, the one-year survival rate of renal transplants is from 93% (from cadaveric donors) to 97% (from living donors), the five-year survival rate is on average 95%. The aim of the study consisted in determining the features of renal graft blood flow in the early post-transplantation period.
Materials And Methods:
The results of operative treatment of 110 patients who underwent orthotopic kidney transplantation for various reasons were analyzed. The indication for transplantation was chronic kidney disease of 5 st in the outcome of the main disease: in 70 (64%) in chronic glomerulonephritis, in 22 (20%) patients in autosomal dominant polycystic kidney disease, 10 (9%) patients in diabetic nephropathy, in 8 (7%) patients in chronic pyelonephritis. The five-year survival rate of the renal graft during catamnestic follow-up was 88%. All patients underwent ultrasound dopplerography of a renal graft in dynamics from the first day to discharge.
Results:
After transplantation of a renal graft, blood flow disorders are caused by swelling in the early postoperative period, but further to discharge there was a normalization of the blood flow rates of the renal graft. Which suggests a satisfactory functional state of the renal graft and is a favorable prognostic feature. Reduced blood flow in the graft and increased resistance index (RI) in ultrasound with dopplerography are signs of developing graft dysfunction.
Conclusion:
In almost all cases, postoperative postoperative renal transplant transplants continued to cause blood flow disturbances due to early postoperative edema. The use of ultrasound and Doppler imaging to assess graft status is a diagnostically valuable non-invasive method.
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