Department of Vascular Surgery, University of Erlangen, Erlangen, Germany.
Department of Nephropathology, University of Erlangen, Erlangen, Germany.
Microcirculation. 2019 Apr;26(3):e12529. doi: 10.1111/micc.12529. Epub 2019 Feb 8.
ICG fluorescence angiography enables a quantitative real-time perfusion assessment in kidney transplantation. The results of intraoperative microperfusion of the kidney allograft were compared to the renal chronicity score in pre-transplantation kidney biopsy specimens. The intrarenal resistance index was calculated by duplex sonography as a method of reference.
Seventy-seven patients with end-stage renal disease undergoing kidney transplantation were prospectively included in two centers. Correlation analysis of chronic changes in kidney biopsy specimens and the IN of ICG fluorescence signal were investigated.
The results yielded a significantly negative correlation for the renal chronicity (r = -0.294, P = 0.017) as well as the intestinal fibrosis and tubular atrophy score (r = -0.328, P = 0.007). There was a significant inverse relationship between the IN and the mean RI values of the upper pole of the kidney allograft.
In summary, fluorescence angiography reflects preexisting morphological changes of the renal cortex. ICG angiography may serve as an alternative method for the assessment of microperfusion of the kidney allograft.
吲哚菁绿荧光血管造影术可实现对肾移植的实时定量灌注评估。本研究将术中肾移植的微血管灌注结果与移植前肾活检标本中的肾脏慢性评分进行了比较。并通过双功能超声计算肾内阻力指数作为参考方法。
本研究前瞻性纳入了两个中心的 77 例终末期肾病患者。研究分析了肾活检标本中慢性改变与 ICG 荧光信号 IN 值之间的相关性。
研究结果显示，肾脏慢性评分（r=-0.294，P=0.017）以及肠纤维化和肾小管萎缩评分（r=-0.328，P=0.007）与 IN 值呈显著负相关。此外，IN 值与肾移植上极的平均 RI 值呈显著负相关。
总之，荧光血管造影术反映了肾皮质的固有形态变化。ICG 血管造影术可能成为评估肾移植微血管灌注的替代方法。
