Measurement of renovascular circulating volume during hypothermic organ perfusion

E.E. de Vries, T.C. van Smaalen, J. Boer, E.R. Hoogland, N.M. Krivitski, M.G. Snoeijs, L.W. van Heurn

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Kidney donation after cardiac death leads to vascular damage as a result of warm ischemia, affecting renovascular circulating volume. Novel ultrasound dilution techniques may be used to measure renovascular circulating volumes during hypothermic machine perfusion of donor kidneys. METHODS: Renovascular circulating volumes of machine-perfused porcine kidneys were repeatedly measured by ultrasound dilution at different perfusion pressures (30, 40, 50, and 60 mm Hg), durations of perfusion (1 and 24 hr), and warm ischemia times (15 and 45 min). Validity of ultrasound dilution was assessed by comparing volume changes after clamping of renal artery branches. RESULTS: Repeatability of ultrasound dilution measurements of renovascular circulating volumes was good (mean coefficient of variation, 7.6%). Renovascular circulating volumes significantly increased with higher perfusion pressures, remained constant over time, and significantly decreased with longer warm ischemia times. Changes in ultrasound dilution measurements after renal artery branch clamping did not correlate with changes in actual perfused volumes. CONCLUSIONS: Ultrasound dilution is a reproducible method to assess renovascular circulating volumes in machine-perfused kidneys, which is susceptible to changes in warm ischemia times. Future studies should evaluate the value of renovascular volume in pretransplantation kidney viability testing.
Original languageEnglish
Pages (from-to)1100-1104
Number of pages5
JournalTransplantation
Volume95
Issue number9
DOIs
Publication statusPublished - 15 May 2013

Keywords

  • Kidney transplantation
  • DCD
  • Machine preservation
  • Viability testing
  • Renovascular volume
  • DECEASED DONOR KIDNEYS
  • DELAYED GRAFT FUNCTION
  • MACHINE PERFUSION
  • PULSATILE PERFUSION
  • COLD-STORAGE
  • DILUTION TECHNIQUE
  • ACCESS FLOW
  • TRANSPLANTATION
  • PRESERVATION
  • HEMODIALYSIS

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