In:
Lasers in Surgery and Medicine, Wiley, Vol. 55, No. 8 ( 2023-10), p. 784-793
Abstract:
Normothermic machine perfusion (NMP) provides a platform for pre‐transplant kidney quality assessment that is essential for the use of marginal donor kidneys. Laser speckle contrast imaging (LSCI) presents distinct advantages as a real‐time and noncontact imaging technique for measuring microcirculation. In this study, we aimed to assess the value of LSCI in visualizing renal cortical perfusion and investigate the additional value of dual‐side LSCI measurements compared to single aspect measurement during NMP. Methods Porcine kidneys were obtained from a slaughterhouse and then underwent NMP. LSCI was used to measure one‐sided cortical perfusion in the first 100 min of NMP. Thereafter, the inferior renal artery branch was occluded to induce partial ischemia and LSCI measurements on both ventral and dorsal sides were performed. Results LSCI fluxes correlated linearly with the renal blood flow ( R 2 = 0.90, p 〈 0.001). After renal artery branch occlusion, absence of renal cortical perfusion could be visualized and semiquantified by LSCI. The overall ischemic area percentage of the ventral and dorsal sides was comparable (median interquartile range [IQR], 38 [24−43] % vs. 29 [17−46]%, p = 0.43), but heterogenous patterns between the two aspects were observed. There was a significant difference in oxygen consumption (mean ± standard deviation [SD], 2.57 ± 0.63 vs. 1.83 ± 0.49 mLO 2 /min/100 g, p 〈 0.001), urine output (median [IQR], 1.3 [1.1−1.7] vs. 0.8 [0.6−1.3] mL/min, p 〈 0.05), lactate dehydrogenase (mean ± SD, 768 ± 370 vs. 905 ± 401 U/L, p 〈 0.05) and AST (mean ± SD, 352 ± 285 vs. 462 ± 383 U/L, p 〈 0.01) before and after renal artery occlusion, while no significant difference was found in creatinine clearance, fractional excretion of sodium, total sodium reabsorption and histological damage. Conclusions LSCI fluxes correlated linearly with renal blood flow during NMP. Renal cortical microcirculation and absent perfusion can be visualized and semiquantified by LSCI. It provides a relative understanding of perfusion levels, allowing for a qualitative comparison between regions in the kidney. Dual‐side LSCI measurements are of added value compared to single aspect measurement and renal function markers.
Type of Medium:
Online Resource
ISSN:
0196-8092
,
1096-9101
Language:
English
Publisher:
Wiley
Publication Date:
2023
detail.hit.zdb_id:
1475539-7
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