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Safety and feasibility of renal blood flow determination during kidney transplant surgery with perfusion ultrasonography.

Publication ,  Journal Article
Aronson, S; Thistlethwaite, RJ; Walker, R; Feinstein, SB; Roizen, MF
Published in: Anesth Analg
February 1995

Contrast-enhanced perfusion patterns of newly transplanted kidneys were determined in 10 patients. Albumin-stabilized sonicated microspheres were injected into the iliac-renal artery of the transplanted kidney while continuous two-dimensional ultrasound images were recorded. Doppler derived resistance index (RI) of the transplanted kidney's blood flow before injection of contrast (0.68 +/- 0.8) did not differ significantly from RI measured immediately after injection (0.72 +/- 0.13) or RI 24 h after surgery (0.69 +/- 0.11). Heart rate, mean arterial pressure, central venous pressure, and electrocardiogram (ECG) signs for ischemia did not change during contrast injections. Renal scintigraphy and renal biopsy revealed acute tubular necrosis and/or rejection in two patients at 24-48 h. Videodensitometry was used to assess the ratio of inner to outer peak pixel intensity from the recorded tomographic images in six patients. In both patients with acute rejection, the inner to outer cortex peak pixel intensity was greater than 1, whereas it was less than 1 in the remaining four patients with normal postoperative renal function. Visual scores (0-3) of contrast enhancement for three doses of Albunex were evaluated (0.5 mL, 1.0 mL, 2.0 mL). Two milliliters always enabled perfusion assessment. In seven patients the identical dose of Albunex was injected immediately before and 30 s after 2 mg of verapamil was injected directly into the renal artery at the time of surgery. The contrast enhancement score before verapamil (1.4 +/- 0.6) was significantly less than the enhancement score after (2.1 +/- 0.6), implying greater renal blood flow after verapamil.(ABSTRACT TRUNCATED AT 250 WORDS)

Duke Scholars

Published In

Anesth Analg

DOI

ISSN

0003-2999

Publication Date

February 1995

Volume

80

Issue

2

Start / End Page

353 / 359

Location

United States

Related Subject Headings

  • Verapamil
  • Ultrasonography
  • Middle Aged
  • Male
  • Kidney Transplantation
  • Kidney
  • Humans
  • Graft Rejection
  • Female
  • Contrast Media
 

Citation

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Aronson, S., Thistlethwaite, R. J., Walker, R., Feinstein, S. B., & Roizen, M. F. (1995). Safety and feasibility of renal blood flow determination during kidney transplant surgery with perfusion ultrasonography. Anesth Analg, 80(2), 353–359. https://doi.org/10.1097/00000539-199502000-00025
Aronson, S., R. J. Thistlethwaite, R. Walker, S. B. Feinstein, and M. F. Roizen. “Safety and feasibility of renal blood flow determination during kidney transplant surgery with perfusion ultrasonography.Anesth Analg 80, no. 2 (February 1995): 353–59. https://doi.org/10.1097/00000539-199502000-00025.
Aronson S, Thistlethwaite RJ, Walker R, Feinstein SB, Roizen MF. Safety and feasibility of renal blood flow determination during kidney transplant surgery with perfusion ultrasonography. Anesth Analg. 1995 Feb;80(2):353–9.
Aronson, S., et al. “Safety and feasibility of renal blood flow determination during kidney transplant surgery with perfusion ultrasonography.Anesth Analg, vol. 80, no. 2, Feb. 1995, pp. 353–59. Pubmed, doi:10.1097/00000539-199502000-00025.
Aronson S, Thistlethwaite RJ, Walker R, Feinstein SB, Roizen MF. Safety and feasibility of renal blood flow determination during kidney transplant surgery with perfusion ultrasonography. Anesth Analg. 1995 Feb;80(2):353–359.

Published In

Anesth Analg

DOI

ISSN

0003-2999

Publication Date

February 1995

Volume

80

Issue

2

Start / End Page

353 / 359

Location

United States

Related Subject Headings

  • Verapamil
  • Ultrasonography
  • Middle Aged
  • Male
  • Kidney Transplantation
  • Kidney
  • Humans
  • Graft Rejection
  • Female
  • Contrast Media