title: Near-infrared spectroscopy as continuous real-time monitoring for kidney graft perfusion.
abstract: BACKGROUND
  Near-infrared spectroscopy (NIRS) is a non-invasive technique designed to study regional oxygenation (rSO(2)) by measuring the absorption of chromophores. This study investigated the role of NIRS in the real-time monitoring of kidney graft perfusion for 72 h post-transplantation.
  
  
  METHODS
  Consecutive children undergoing living related donor (LRD) or deceased donor (DD) kidney transplantation (KTP) were prospectively enrolled between April 2010 and August 2011. Renal rSO(2) values were registered continuously for 3 days and correlated with hourly urine output, serum creatinine, and urinary neutrophil gelatinase-associated lipocalin (u-NGAL).
  
  
  RESULTS
  Twenty-four children were included, 6 underwent LRD and 18 DD KTP. Median age was 12.5 years (interquartile range [IQR] 3.5-16.6) and median body weight was 37 kg (IQR 13-49.7). Four patients experienced delayed graft function (DGF). Renal Doppler ultrasound showed normal vascularization patterns in all children. Median basal renal rSO(2) value was 68.8 % (IQR 59.3-76.2), significantly lower than the end-of-period result (83.6 %; IQR 79.2-90.4; p < 0.0001). Renal rSO(2) values showed significant correlation with serum creatinine (rs = -0.62; p < 0.05) and estimated glomerular filtration rate (eGFR) (rs = 0.64; p < 0.05). No correlation was shown between rSO(2) and diuresis. Increased rSO(2) was also found in patients who experienced DGF. u-NGAL exhibited a trend toward a decrease from baseline in both DD and LRD KTPs, with a strong negative correlation with rSO(2).
  
  
  CONCLUSIONS
  rSO(2) assessed by NIRS strongly correlates with common markers of kidney graft function and perfusion, allowing continuous real-time monitoring of blood flow in renal grafts.
authors.affiliation: Pediatric Nephrology, Dialysis and Transplant Unit, Department of Paediatrics, University-Hospital, Via Giustiniani 3, 35128, Padua, Italy, enrico.vidal@inwind.it.
authors.forename: Enrico
authors.initials: E
authors.lastname: Vidal
authors.forename: Angela
authors.initials: A
authors.lastname: Amigoni
authors.forename: Valentina
authors.initials: V
authors.lastname: Brugnolaro
authors.forename: Giulia
authors.initials: G
authors.lastname: Ghirardo
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Gamba
authors.forename: Andrea
authors.initials: A
authors.lastname: Pettenazzo
authors.forename: Giovanni Franco
authors.initials: GF
authors.lastname: Zanon
authors.forename: Chiara
authors.initials: C
authors.lastname: Cosma
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
authors.forename: Luisa
authors.initials: L
authors.lastname: Murer
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003199:Computer Systems; D051799:Delayed Graft Function; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008991:Monitoring, Physiologic; D011446:Prospective Studies; D012079:Renal Circulation / Q000502:physiology; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D013458:Sulfur Dioxide / Q000378:metabolism
chemical_list: D013458:Sulfur Dioxide