Real time monitoring of intraoperative allograft vitality

Abstract

URING the transplantation procedure, the organ preserved under low temperature is shifted toward the normothermic range. This temperature change shifts the mitochondria toward a more oxidized state and the mitochondria will depend on adequate tissue oxygenation. The successful rate of organ transplantation depends on adequate microcirculatory blood flow (O2 supply) and recovery of mitochondrial function to the normal range. Attempts to monitor kidney microcirculatory blood flow or mitochondrial NADH redox state were published. Based on the early studies, Thornilley et al applied the NADH fluorometry technique to study the kidney and liver during transplantation. 1 In parallel, Lu et al applied the laser Doppler flowmetry to study kidney blood flow under various physiological conditions. 2 As seen, those attempts to monitor the kidney during transplantation suggest the need as well as the value of the results in evaluating the kidney for its viability. In this report we are presenting for the first time preliminary results of a new device that enables the real time simultaneous monitoring of kidney microcirculatory blood flow and the mitochondrial NADH redox state in experimental animals as well as during human kidney transplantation. It is assumed, according to the published material and our preliminary studies, 3 that the monitoring of the microcirculatory blood flow and volume together with the mitochondrial NADH redox state will provide real time information on the viability of the transplanted kidney.