Abstract
Kidney transplants from living donors have a higher survival
rate than cadaveric kidneys probably due to shorter ischemia time. We
hypothesized that intraoperative kidney oxygenation (kox) predicts
postoperative transplant function. Thus, we measured kox (microvascular
hemoglobin oxygen saturation in %) by reflectance spectrophotometry and
microcirculatory kidney perfusion by laser Doppler flowmetry (O2C, Lea,
Germany) 5 and 30 min after kidney reperfusion on the surface of the
transplant in 53 renal transplant patients. Kox improved 30 min after
reperfusion compared to 5 min (from 67 to 71%, p<0.05) probably due to
higher oxygen extraction shortly after reperfusion. Kox correlated with
mean arterial blood pressure and central venous pH (p<0.01). Most
importantly, kox was significantly higher in kidneys from living compared
to cadaver donors (74 vs. 63%) and in kidneys with good as opposed to
those with poor postoperative function (71 vs. 45%). Finally, kox
correlated positively with cold ischemia time and postoperative creatinine
clearance and negatively with plasma creatinine, need for hemodialysis and
hospital length of stay. Thus, the intraoperative measurement of tissue
oxygenation in kidney transplants is predictive of early postoperative
kidney function. Further studies should look at the effects of therapeutic
maneuvers aimed at improving kidney oxygenation intraoperatively.
Original language | English |
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Article number | TA20 |
Pages (from-to) | 5 |
Number of pages | 1 |
Journal | Shock |
Volume | 32 |
Issue number | suppl. 1 |
Publication status | Published - 26-Sep-2009 |
Event | 13th Congress of the European-Shock-Society - Lisbon, Portugal Duration: 24-Sep-2009 → 26-Sep-2009 |