Abstract
.Transplantation of kidneys results in delayed graft function in as many as 40% of cases. During the organ transplantation process, donor kidneys undergo a period of cold ischemic time (CIT), where the organ is preserved with a cold storage solution to maintain tissue viability. Some complications observed after grafting may be due to damage sustained to the kidney during CIT. However, the effects due to this damage are not apparent until well after transplant surgery has concluded. To this end, we have used spatial frequency domain imaging (SFDI) to measure spatially resolved optical properties of porcine kidneys over the course of 80-h CIT. During this time, we observed an increase in both reduced scattering () and absorption () coefficients. The measured scattering parameter increased until 24 h of CIT, then returned toward baseline during the remaining duration of the imaging sequence. These results show that the optical properties of kidney tissue change with increasing CIT and suggest that continued investigation into the application of SFDI to kidneys under CIT may lead to the development of a noninvasive method for assessing graft viability.
Highlights
Renal failure, due to complications such as glomerular disease, diabetes, vascular disease, or hypertension, often necessitates a kidney transplant
In the United States, the number of kidney transplantations makes up the majority of organ transplantation procedures at around 21,000 annually.[1]
spatial frequency domain imaging (SFDI)-derived reduced scattering and scattering b parameter suggest the occurrence of structural changes within excised kidneys during the period of cold ischemic time (CIT)
Summary
Due to complications such as glomerular disease, diabetes, vascular disease, or hypertension, often necessitates a kidney transplant. It is estimated that as many as 40% of deceased donor kidneys undergo some kind of delayed graft function.[8] As a result, patients must undergo dialysis therapy after transplantation, which increases risk for acute rejection of the grafted kidney.[9] it is difficult to predict if the patient will experience delayed graft function until after transplantation. Explicit criteria for discarding potential donor kidneys are not standardized, which has led to high discard rates within the United States.[10] In 2015, almost one-fifth of procured kidneys were discarded.[11] The discard rate is higher (42%) in cases of marginal donors, who have increased risk factors such as advanced age, hypertension, or diabetes.[12] Evaluation of pretransplant biopsies is time consuming, subject to variable assessment, and is performed in fewer than 20% of standard donor cases and fewer than 80% of marginal donor cases.[13]
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