L. Thebridge , C. Fisher , V. Puttaswamy , C. Pollock , J. Clarke
{"title":"肾移植术中及术后早期皮质阻力指数:根据移植物功能和扫描时间的代表性值","authors":"L. Thebridge , C. Fisher , V. Puttaswamy , C. Pollock , J. Clarke","doi":"10.1016/j.wfumbo.2025.100093","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Intra-operative ultrasound during renal transplantation identifies technical abnormalities allowing immediate surgical correction as required. Cortical resistive indices (RIs) assess graft perfusion and are now measured intra-operatively. The aim of this study was to evaluate RIs intra-operatively, and to 30 days post-operatively.</div></div><div><h3>Methods</h3><div>RIs in consecutive single renal grafts in adults were analysed from 246 grafts scanned intra-operatively, on day 1 post-operatively and subsequently according to physician preference, and 125 grafts scanned intra-operatively to day 30 post-operatively according to a formal protocol.</div></div><div><h3>Results</h3><div>There was delayed graft function (DGF) in 125 grafts. The mean (±sem) intra-operative RI of 0.599 (±0.009) was significantly lower (p < 0.001) than post-operatively, with the highest RIs on days 3 and 7. RIs on day 30 were similar to day 1. RIs in grafts with function were significantly lower than grafts still requiring dialysis. Mean (±sem) cortical RIs on post-operative days 1, 3, 7 and 30 in functioning grafts were 0.662(±0.005), 0.712(±0.008), 0.703(±0.007) and 0.689 (±0.006) respectively, and in grafts still requiring dialysis 0.721(±0.010), 0.780(±0.010), 0.793(±0.011) and 0.751 (±0.034). The intra-operative RI predicted DGF (AUROC 0.774) as effectively as donor status (live/deceased) (AUROC 0.767). For deceased donor grafts, intra-operative RI was a more effective predictor (AUROC 0.710) than type of donor (DCD/DBD) (AUROC 0.610).</div></div><div><h3>Conclusions</h3><div>Intra-operative RIs are significantly lower than post-operatively and are indicative of post-operative graft function. Post-operative RIs in non-functioning grafts are consistently higher than in functioning grafts. Observed RIs differ according to the post-operative day of scan, which therefore should also be reported.</div></div>","PeriodicalId":101281,"journal":{"name":"WFUMB Ultrasound Open","volume":"3 2","pages":"Article 100093"},"PeriodicalIF":0.0000,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intra-operative and early post-operative cortical resistive indices in renal transplantation: Representative values according to graft function and time of scan\",\"authors\":\"L. Thebridge , C. Fisher , V. Puttaswamy , C. Pollock , J. Clarke\",\"doi\":\"10.1016/j.wfumbo.2025.100093\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Intra-operative ultrasound during renal transplantation identifies technical abnormalities allowing immediate surgical correction as required. Cortical resistive indices (RIs) assess graft perfusion and are now measured intra-operatively. The aim of this study was to evaluate RIs intra-operatively, and to 30 days post-operatively.</div></div><div><h3>Methods</h3><div>RIs in consecutive single renal grafts in adults were analysed from 246 grafts scanned intra-operatively, on day 1 post-operatively and subsequently according to physician preference, and 125 grafts scanned intra-operatively to day 30 post-operatively according to a formal protocol.</div></div><div><h3>Results</h3><div>There was delayed graft function (DGF) in 125 grafts. The mean (±sem) intra-operative RI of 0.599 (±0.009) was significantly lower (p < 0.001) than post-operatively, with the highest RIs on days 3 and 7. RIs on day 30 were similar to day 1. RIs in grafts with function were significantly lower than grafts still requiring dialysis. Mean (±sem) cortical RIs on post-operative days 1, 3, 7 and 30 in functioning grafts were 0.662(±0.005), 0.712(±0.008), 0.703(±0.007) and 0.689 (±0.006) respectively, and in grafts still requiring dialysis 0.721(±0.010), 0.780(±0.010), 0.793(±0.011) and 0.751 (±0.034). The intra-operative RI predicted DGF (AUROC 0.774) as effectively as donor status (live/deceased) (AUROC 0.767). For deceased donor grafts, intra-operative RI was a more effective predictor (AUROC 0.710) than type of donor (DCD/DBD) (AUROC 0.610).</div></div><div><h3>Conclusions</h3><div>Intra-operative RIs are significantly lower than post-operatively and are indicative of post-operative graft function. Post-operative RIs in non-functioning grafts are consistently higher than in functioning grafts. Observed RIs differ according to the post-operative day of scan, which therefore should also be reported.</div></div>\",\"PeriodicalId\":101281,\"journal\":{\"name\":\"WFUMB Ultrasound Open\",\"volume\":\"3 2\",\"pages\":\"Article 100093\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-08-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"WFUMB Ultrasound Open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2949668325000151\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"WFUMB Ultrasound Open","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2949668325000151","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Intra-operative and early post-operative cortical resistive indices in renal transplantation: Representative values according to graft function and time of scan
Background
Intra-operative ultrasound during renal transplantation identifies technical abnormalities allowing immediate surgical correction as required. Cortical resistive indices (RIs) assess graft perfusion and are now measured intra-operatively. The aim of this study was to evaluate RIs intra-operatively, and to 30 days post-operatively.
Methods
RIs in consecutive single renal grafts in adults were analysed from 246 grafts scanned intra-operatively, on day 1 post-operatively and subsequently according to physician preference, and 125 grafts scanned intra-operatively to day 30 post-operatively according to a formal protocol.
Results
There was delayed graft function (DGF) in 125 grafts. The mean (±sem) intra-operative RI of 0.599 (±0.009) was significantly lower (p < 0.001) than post-operatively, with the highest RIs on days 3 and 7. RIs on day 30 were similar to day 1. RIs in grafts with function were significantly lower than grafts still requiring dialysis. Mean (±sem) cortical RIs on post-operative days 1, 3, 7 and 30 in functioning grafts were 0.662(±0.005), 0.712(±0.008), 0.703(±0.007) and 0.689 (±0.006) respectively, and in grafts still requiring dialysis 0.721(±0.010), 0.780(±0.010), 0.793(±0.011) and 0.751 (±0.034). The intra-operative RI predicted DGF (AUROC 0.774) as effectively as donor status (live/deceased) (AUROC 0.767). For deceased donor grafts, intra-operative RI was a more effective predictor (AUROC 0.710) than type of donor (DCD/DBD) (AUROC 0.610).
Conclusions
Intra-operative RIs are significantly lower than post-operatively and are indicative of post-operative graft function. Post-operative RIs in non-functioning grafts are consistently higher than in functioning grafts. Observed RIs differ according to the post-operative day of scan, which therefore should also be reported.