Purpose:

Laser speckle flowgraphy (LSFG) is a device to monitor cutaneous and ocular fundus blood flow. However, there is no report that the device was used for the blood flow of intra-abdominal organs. The aim of this study reveals the usability of LSFG for blood flow of graft in renal transplants.

Methods:

We analyzed 50 patients who received a live-related donor renal transplant at our center between October 2015 and August 2017. The blood flow at the anterior surface of renal graft was estimated using LSFG device at 5, 10 and 60 min after reperfusion. The device was placed 45cm above a graft and the measurement time was 4 seconds 3 times in each section. Mean blur rate (MBR) (arbitrary unit, a.u.) and beat strength (BS: maximum MBR-minimum MBR) (a.u.) were available for evaluated values of the blood flow. The patients were divided into two groups as follows: initial urine (IU) time <20 min in 18 cases (group A) and ≥20 min in 32 cases (group B). The time to the nadir creatinine level (s-Cr) after transplantation (day), MBR and BS were compared between both groups.

Results:

Recipient age was 36 (interquartile range, IQR: 10.5-57.8) y/o, gender (male/female) were 35 and 15, respectively. Donor age was 52 (IQR: 39.8-64.3) y/o, gender (male/female) were 20 and 30, respectively. In all patients, MBR had increased over time (5, 10 and 60 min; 491.6±139.7, 543.1±135.2 and 572.1±112.2). On the contrary, BS became attenuated (128.9±67.1, 117.2±66.4 and 81.2±36.4). The time of the nadir s-Cr was comparative in the both groups (group A vs. group B: 7.3±4.4 vs. 8.6±7.7). There were no significant differences for MBR between both groups at 5, 10 and 60 min after reperfusion (group A vs. B: 516.0±157.8, 557.2±144.7 and 571.9±111.6 vs. 458.0±104.5, 523.7±121.8 and 572.2±115.9). BS at 5, 10 and 60 min after reperfusion in the group A significantly differ from those in group B (group A vs. B: 109.4±11.8, 95.7±45.9 and 71.8±30.3 vs. 155.9±13.9, 147.0±78.9 and 94.9±40.2) (p<0.05: 5, 60min, p<0.01: 10min).

Conclusions:

The low BS influenced the expression of early IU time. The intraoperative evaluation of blood flow at the surface of graft using LSFG may help to be useful for prediction of early graft function.

CITATION INFORMATION: Muramatsu M., Itabashi Y., Takahashi Y., Sakurabayashi K., Mizutani T., Hyodo Y., Hamasaki Y., Kawamura T., Sakai K., Shishido S. The Efficacy of Laser Speckle Flowgraphy Device for Intraoperative Evaluation of Renal Blood Flow after Reperfusion Am J Transplant. 2017;17 (suppl 3).

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