The use of an implantable Doppler flow probe in kidney transplantation: first report in the literature

Abstract

Objectives: After a kidney transplant, surveillance of the graft blood supply is crucial. Any delay in detecting compromised graft perfusion affects organ survival. Current practice uses Doppler ultrasound to monitor vessel patency and graft perfusion and is performed repeatedly after kidney and pancreas transplant. We have used an implantable probe that allows for easy vessel attachment and safe, continuous, audible monitoring of vascular anastomoses. It has been used to observe microvascular tissue transplants, free flaps, and pediatric liver transplants, but as yet, it has not been used to monitor kidney allografts. We feel a transplanted kidney could benefit greatly from continuous blood flow monitoring.

Materials and methods: To assess the feasibility of the probe in a renal transplant patient, we used the probe in 15 consecutive transplant recipients.

Results: Only 1 Doppler ultrasound was ordered during the 15 admissions compared with scans that are routinely ordered. There were no complications and all probes were removed easily.

Conclusions: This probe can identify transplanted organs that are threatened owing to flagging or cessation of the blood supply, and allow for immediate intervention. This technique may save precious organs. Further controlled studies are needed to assess the use of the probe in routine clinical practice.