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. 2019 Mar;51(2):328-333.
doi: 10.1016/j.transproceed.2018.12.011. Epub 2018 Dec 13.

Utility of Basal Regional Oximetry Saturation for the Diagnosis of Acute Tubular Necrosis in the Early Postoperative Period Following Kidney Transplantation

D V Pérez Civantos  1 , A Muñoz Cantero  2 , M Robles Marcos  2 , H Fariñas Seijas  3 , M A Santiago Triviño  2 , M D Pérez Frutos  2 , B Jimeno Torres  2
Affiliations

Utility of Basal Regional Oximetry Saturation for the Diagnosis of Acute Tubular Necrosis in the Early Postoperative Period Following Kidney Transplantation

D V Pérez Civantos et al. Transplant Proc. 2019 Mar.

Abstract

Introduction: Adequate perfusion and oxygenation to a renal graft after transplantation are essential for its viability. Regional renal oximetry (RSrO2) through near-infrared spectroscopy shows real-time oxygen content of the graft.

Methods: A prospective study was conducted. We enrolled consecutive patients undergoing renal transplant from deceased donors from January 2015 to February 2016. RSrO2 was continuously measured for 24 hours, analyzed, and correlated with other clinical data such as hemoglobin, mixed central venous oxygen saturation (ScvO2), blood pressure, central venous pressure, diuresis, and blood lactate. Severity disease scales, cold and warm ischemia times were also measured, as well as the pulsatility index (PI) and resistive index (RI) by Doppler-dúplex ultrasound (DUS) at 24 hours. A statistical analysis with IBM SPSS version 22 (IBM, Armonk, NY) using a Pearson correlation was carried out.

Results: RSrO2 could anticipate serious arterial and bleeding events showing a maintained decrease >10% from basal data. A significant correlation was found between RSrO2 with lactate at 8 and 24 hours (P = .005 and P = .000 respectively), as well as with initial diuresis at hour 3 (P = .010), initial ScvO2 (P = .010), Sequential Organ Failure Assessment (P = .015), and warm ischemia (P = .035). A significant correlation was also detected between cold ischemia, RI, and diuresis (P = .037 and P = .049 respectively). No correlation was found between RSrO2 and DUS data.

Conclusion: RSrO2 is a useful tool for initial kidney transplant grafts monitoring and could give early warnings regarding bleeding and arterial thrombosis. RSrO2 is found to have a correlation with initial diuresis, blood lactate, and ScvO2. No matching data with Doppler was found.

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