title: Fast detection of renal ischemia in transplanted kidneys with delayed graft function-an experimental study.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors: Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark. anna.keller@ki.au.dk
authors: Anna K
authors: AK
authors: Keller
authors: Troels M
authors: TM
authors: Jørgensen
authors: Dorthe M
authors: DM
authors: Vittrup
authors: Ulrik K
authors: UK
authors: Kjerkegaard
authors: Bente
authors: B
authors: Jespersen
authors: Søren R P
authors: SR
authors: Krag
authors: Bo M
authors: BM
authors: Bibby
authors: Lars B
authors: LB
authors: Stolle
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D057785:Catheters; D050377:Cold Ischemia / Q000009:adverse effects; D003250:Constriction; D051799:Delayed Graft Function / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D004195:Disease Models, Animal; D004231:Diuresis; D042241:Early Diagnosis; D005919:Glomerular Filtration Rate; D018698:Glutamic Acid / Q000378:metabolism; D005990:Glycerol / Q000378:metabolism; D007511:Ischemia / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D007672:Kidney Cortex / Q000098:blood supply* / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D054834:Lipocalins / Q000097:blood; D017551:Microdialysis / Q000295:instrumentation; D011237:Predictive Value of Tests; D012078:Renal Artery Obstruction / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D013552:Swine; D013997:Time Factors
chemical_list: D015415:Biomarkers; D054834:Lipocalins; D018698:Glutamic Acid; D005990:Glycerol