Use of Intraoperative Duplex Ultrasound and Resistance Index Reduces Complications in Living Renal Donor Transplantation.

Détails

ID Serval
serval:BIB_AC2F66864498
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Use of Intraoperative Duplex Ultrasound and Resistance Index Reduces Complications in Living Renal Donor Transplantation.
Périodique
Transplantation proceedings
Auteur(s)
Bejic M., Déglise S., Venetz J.P., Nseir G., Dubuis C., Saucy F., Berard X., Meuwly J.Y., Corpataux J.M.
ISSN
1873-2623 (Electronic)
ISSN-L
0041-1345
Statut éditorial
Publié
Date de publication
12/2018
Peer-reviewed
Oui
Volume
50
Numéro
10
Pages
3192-3198
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
The treatment of choice in end-stage renal disease is transplantation. Hemodynamic disturbances can evoke graft loss, while early ultrasound identification of vascular problems improves outcome. The aim of this study was to identify differences in postoperative complications with and without systematic intraoperative Doppler ultrasound use.
The primary outcome was the postoperative rate of complications and the secondary aim was to find a predictive resistance index cut-off value, which would show where surgical reintervention was necessary. Over a 10-year period, 108 renal transplants were performed from living donors at our institution. In group 1 (n = 67), intraoperative duplex ultrasound and intraparenchymatous resistance index measurements assessed patients, while in group 2 (n = 41), no ultrasound was performed.
There were no intergroup differences in the overall postoperative complication rate or in benefit to graft or patient survival with Doppler use. However, significantly more vascular complications (10% vs 0%, P = .02) and more acute rejections (37% vs 10%) occurred in group 2 than in group 1. Therefore, an intraoperative cut-off value of the resistance index 0.5 was proposed to justify immediate surgical revision.
This is the first report demonstrating benefits of systematic intraoperative Doppler ultrasound on postoperative complications in renal transplantation from living donors. Our results support surgical revision with a resistance index <0.5.
Mots-clé
Adolescent, Adult, Aged, Child, Child, Preschool, Female, Humans, Kidney Failure, Chronic/surgery, Kidney Transplantation/adverse effects, Living Donors, Male, Middle Aged, Postoperative Complications/diagnosis, Ultrasonography, Doppler/methods, Vascular Diseases/diagnosis, Vascular Diseases/etiology, Vascular Resistance, Young Adult
Pubmed
Web of science
Création de la notice
20/01/2019 16:33
Dernière modification de la notice
20/08/2019 16:16
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