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Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation
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Enhancing Kidney Quality Assessment: Power Doppler During Normothermic Machine Perfusion.

Yitian Fang1, Anton V Nikolaev2, Jeroen Essers3,4,5

  • 1Division of HPB and Transplant Surgery, Department of Surgery, Transplant Institute, Erasmus Medical Center, Rotterdam, the Netherlands.

Artificial Organs
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Summary
This summary is machine-generated.

Power Doppler (PD) imaging effectively assesses kidney quality during normothermic machine perfusion (NMP). PD metrics strongly correlate with renal viability, offering a valuable alternative for evaluating marginal donor kidneys.

Keywords:
Doppler ultrasoundexperimental animal modelkidney functionquality assessment

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Area of Science:

  • Transplantation Medicine
  • Medical Imaging
  • Nephrology

Background:

  • Marginal donor kidneys are crucial for addressing organ shortages in transplantation.
  • Normothermic machine perfusion (NMP) is an emerging technique for assessing kidney viability.
  • Objective assessment of kidney quality during NMP is essential.

Purpose of the Study:

  • To evaluate the added value of Power Doppler (PD) imaging in assessing kidney quality during NMP.
  • To determine the correlation between PD imaging metrics and kidney function parameters.
  • To assess the diagnostic accuracy of PD imaging in differentiating kidney viability.

Main Methods:

  • Porcine kidneys (n=22) underwent 2-hour NMP.
  • Kidneys were classified into functional groups based on creatinine clearance (CrCl) and oxygen consumption (VO2).
  • PD imaging metrics (VI, FI, VFI) and renal blood flow (RBF) were measured and correlated with CrCl and VO2.

Main Results:

  • PD metrics, including vascularization index (VI), flow index (FI), and vascularization flow index (VFI), showed significant correlations with CrCl and VO2.
  • At 120 minutes, PD metrics demonstrated high diagnostic accuracy (AUC > 0.92) in differentiating kidney function.
  • Specific cutoff values for VI, FI, and VFI achieved high sensitivity and specificity in identifying lower-functioning kidneys.

Conclusions:

  • PD imaging metrics strongly correlate with renal viability and function during NMP.
  • PD imaging provides an effective and potentially superior method for kidney quality assessment compared to traditional RBF measurements.
  • PD imaging offers a valuable tool for improving the selection of marginal donor kidneys for transplantation.