EAU 2019: Early Experience on IR Technology for Kidney Graft Re-Perfusion Assessment

Barcelona, Spain (UroToday.com) Dr. Veneziano gave a presentation on the ESUT-YAUWP project. It is well known that the temperature of a kidney transplant should not fall below 20 ° C in order to preserve the perfusion of the kidney and optimize the outcomes of the subsequent transplantation.

Previously, Indocyanine Green was used to assess the degree of ischemia during reperfusion, which required physical contact with the kidney. But the recent introduction of a new technology called Infrared thermography (IRT) could change everything and become a new indicator of the early development of ischemic changes in the transplanted kidney and a predictor of the success of the operation.

The authors proposed the following study design: Between Feb 2016 and May 2017, 12 patients (mean age 48 years) were enrolled in 2 centers and underwent kidney transplants. Patient's blood pressure was recorded in T2 and T3, re-perfusion. The IRЕ images obtained during the procedures were analyzed using FLIR Tools © software. As a control arm, we’ve corrected the correlation of the parenchyma, renal artery pulse, and the renal vein flow. Scores were collected at T2, T2 + 10 and T3, ranging from 1 (poor) to 5 (optimal).

Graft temperature was recorded along pre-scheduled time-points during open KT. 

A total of 10 patients out of 12 had an immediate post-op graft resumption and only in 2 had complications after de-clamping: polar thrombosis (p5) arterial anastomosis bleeding (p9). In these 2 cases TIR at T3 with associated delayed graft function. A surgeon score of 8/20 with a surgeon score of 8/20 and a regular surgeon score of 18/20.

Dr. Veneziano concluded that IRT imaging can be applied to early graft re-perfusion assessment with clinically valuable results. Bench solution re-perfusion before a real complication occurs. They are still a critical integration, for a wise case-by-case evaluation. We thank the authors and look forward to new data from this prospective study, which can predict the success of the operation, which will facilitate the work of surgeons and, of course, improve the quality of life of patients with chronic kidney disease. 

Presented by: Domenico Veneziano, MD, Grande Ospedale Metropolitano BMM, Department of Urology and Kidney Transplant, Reggio Calabria, Italy 

Written by: Ali Stanislav Ph.D., MD, Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia, and Zhamshid Okhunov, MD, Twitter: @OkhunovZham, Department of Urology, the University of California, Irvine, California at the 34th European Association of Urology (EAU 2019) #EAU19, conference in Barcelona, Spain, March 15-19, 2019.