Affiliation:
1. Comparative Medicine Lab, Department of Clinical Medicine Aarhus University Aarhus Denmark
2. Department of Renal Medicine Aarhus University Hospital Aarhus Denmark
3. Centre for Functionally Integrative Neuroscience, Department of Clinical Medicine Aarhus University Aarhus Denmark
4. Department of Radiology Aarhus University Hospital Aarhus Denmark
Abstract
AbstractBackgroundValidated quantitative biomarkers for assessment of renal graft function during normothermic machine perfusion (NMP) conditions are lacking. The aim of this project was to quantify cortex microperfusion during ex vivo kidney perfusion using laser speckle contrast imaging (LSCI), and to evaluate the sensitivity of LSCI when measuring different levels of renal perfusion. Furthermore, we aimed to introduce LSCI measurements during NMP in differentially damaged kidneys.MethodsEleven porcine kidneys were nephrectomized and perfused ex vivo. Cortex microperfusion was simultaneously monitored using LSCI. First, a flow experiment examined the relationship between changes in delivered renal flow and corresponding changes in LSCI‐derived cortex microperfusion. Second, renal cortical perfusion was reduced stepwise by introducing a microembolization model. Finally, LSCI was applied for measuring renal cortex microperfusion in kidneys exposed to minimal damage or 2 h warm ischemia (WI).ResultsCortex microperfusion was calculated from the LSCI‐obtained data. The flow experiment resulted in relatively minor changes in cortex microperfusion compared to the pump‐induced changes in total renal flow. Based on stepwise injections of microspheres, we observed different levels of cortex microperfusion that correlated with administrated microsphere dosages (r2 = 0.95–0.99). We found no difference in LSCI measured cortex microperfusion between the kidneys exposed to minimal damage (renal cortex blood flow index, rcBFI = 2090–2600) and 2 h WI (rcBFI = 2189–2540).ConclusionsBased on this preliminary study, we demonstrated the feasibility of LSCI in quantifying cortex microperfusion during ex vivo perfusion. Furthermore, based on LSCI‐measurements, cortical microperfusion was similar in kidneys exposed to minimal and 2 h WI.
Subject
Biomedical Engineering,General Medicine,Biomaterials,Medicine (miscellaneous),Bioengineering
Reference27 articles.
1. Global epidemiology of end‐stage kidney disease and disparities in kidney replacement therapy;Thurlow JS;Am J Nephrol,2021
2. Impact of cadaveric renal transplantation on survival in patients listed for transplantation;Oniscu GC;J Am Soc Nephrol,2005
3. Elung‐JensenT.Kronisk nyresygdom og kronisk nyresvigt Sundhed.dk. Available from:https://www.sundhed.dk/sundhedsfaglig/laegehaandbogen/nyrer‐og‐urinveje/tilstande‐og‐sygdomme/nyresygdomme/kronisk‐nyresygdom‐og‐kronisk‐nyresvigt/.
4. Organ donation in the US and Europe: the supply vs demand imbalance;Lewis A;Transplant Rev (Orlando),2021
5. Marginal kidney donor;Gopalakrishnan G;Indian J Urol,2007