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133. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

26.04. - 29.04.2016, Berlin

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Intraoperative arterial blood flow measurement is predictive for primary graft function in kidney transplantation

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  • Michael Ströhlein - Klinikum Köln-Merheim, Universität Witten-Herdecke, Klinik für Viszeral-, Gefäss- und Transplantationschirurgie, Köln, Deutschland
  • Johannes Volland - Klinikum Köln-Merheim, Universität Witten-Herdecke, Klinik für Viszeral-, Gefäss- und Transplantationschirurgie, Köln, Deutschland
  • Dirk Rolf Bulian - Klinikum Köln-Merheim, Universität Witten-Herdecke, Klinik für Viszeral-, Gefäss- und Transplantationschirurgie, Köln, Deutschland
  • Jonas Lange - Klinikum Köln-Merheim, Universität Witten-Herdecke, Klinik für Viszeral-, Gefäss- und Transplantationschirurgie, Köln, Deutschland
  • Ulrich Lange - Klinikum Köln-Merheim, Universität Witten-Herdecke, Medizinische Klinik I, Köln, Deutschland
  • Wolfgang Arns - Klinikum Köln-Merheim, Universität Witten-Herdecke, Medizinische Klinik I, Köln, Deutschland
  • Markus Maria Heiss - Klinikum Köln-Merheim, Universität Witten-Herdecke, Klinik für Viszeral-, Gefäss- und Transplantationschirurgie, Köln, Deutschland

Deutsche Gesellschaft für Chirurgie. 133. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 26.-29.04.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16dgch105

doi: 10.3205/16dgch105, urn:nbn:de:0183-16dgch1056

Published: April 21, 2016

© 2016 Ströhlein et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Background: Primary graft function after kidney transplantation is influenced by multiple parameters like graft age and quality, ischemia time, morbidity of the recipient, surgical problems etc.. Up to date, there is no quantitative parameter to be prognostic for primary graft function. Aim of study was to investigate the role of intraoperative arterial blood flow measurement after reperfusion to predict primary graft function.

Materials and methods: Intraoperative arterial blood flow (IABF) measurement was performed by a standardized method with a Medistim device. Primary graft function was evaluated by creatinine measurement and calculation of the glomerular flow rate (GFR) at discharge. Further parameters to be assessed included ischemia time, vascular resistance, age, graft quality and age. Correlation analysis, student´s t-test and multivariate analysis were used for statistical calculation.

Results: IABF was measured in 221 patients. Mean IABF was 236,9 ml/min (SD 146). Mean GFR was 43,5 ml/min/1,73m2 (SD 15). 163 / 221 patients showed primary urine production (73,8%). IABF correlated with GFR (p<0.006) and creatinine (p=0.034) at discharge. Further significant correlations were found for ischemia time and recipient age. Interestingly, there was no correlation between IABF and primary urine production.

Conclusion: IABF was found to be a prognostic parameter for primary graft function in kidney transplantation. Therefore, IABF measurement could be of great value for interpretation of the postoperative course of patients with kidney transplantation.