Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
Transplantation. 2013 Jan 27;95(2):275-9. doi: 10.1097/TP.0b013e318276a1c8.
The newly transplanted kidney is difficult to monitor with regard to postoperative vascular thrombosis, especially when there is delayed graft function. We evaluated microdialysis as a tool for early ischemia detection in porcine kidneys with delayed graft function early after transplantation.
Sixteen pigs were transplanted with 26-hr cold ischemia kidneys. A microdialysis catheter was placed in the lateral renal cortex. Five hours after graft reperfusion, the pigs were randomized to renal arterial clamping or open artery, n=8 in each group, and further observed for 2 hr.
The diuresis and glomerular filtration rate were low and decreasing throughout the study, with no significant differences between groups. Until arterial clamping, there were no significant differences in the development of local renal metabolites between the two groups. Renal artery clamping immediately caused significantly different development of all metabolites (P<0.02 for all) compared to the open artery group. After clamping, levels of glutamate and glycerol were significantly increased within 30 min (P=0.0049 and P=0.0061, respectively).
Microdialysis provided an early warning of arterial occlusion in transplanted grafts with delayed graft function. It may become a valuable tool for postoperative monitoring and detection of thrombosis after renal transplantation.
新移植的肾脏在术后血管血栓形成方面难以监测，特别是在出现移植物功能延迟时。我们评估了微透析技术作为一种工具，用于检测移植后早期出现移植物功能延迟的猪肾脏的早期缺血情况。
16 头猪接受了经过 26 小时冷缺血的肾脏移植。将微透析导管置于侧肾皮质中。在移植后 5 小时，将猪随机分为肾动脉夹闭组或开放动脉组，每组 8 头，进一步观察 2 小时。
在整个研究过程中，尿量和肾小球滤过率均较低且逐渐下降，两组之间无显著差异。在动脉夹闭之前，两组局部肾代谢产物的发展没有显著差异。与开放动脉组相比，肾动脉夹闭立即导致所有代谢产物的发展明显不同（所有 P<0.02）。夹闭后，谷氨酸和甘油水平在 30 分钟内显著升高（分别为 P=0.0049 和 P=0.0061）。
微透析术为移植物功能延迟的移植肾动脉闭塞提供了早期预警。它可能成为肾移植后术后监测和血栓检测的有价值工具。
