THE INFLUENCE OF IMMEDIATE GRAFT BLOOD FLOW ON EARLY GRAFT FUNCTION

Abstract

Introduction: The aim of this study is to evaluate the impact of intraoperative allograft vascular flow on the early kidney graft function. Methods: A total of 47 patients underwent kidney transplantation from January 2017 to June 2019 at Linkou Chang Gung Memorial Hospital. The majority anastomosis of graft vessels were done with end-to-side manner to the external iliac vessels. Real-time graft blood flow was measured with transit time flowmeter(Transonic HT353) after ureteroneocystostomy. Graft arterial and venous blood glow was measured separately. The early outcomes including postoperative creatinine level and daily urine output were analized accordingly. Results: The median age was 45.7(13-68) years and 22(46.8%) patients were female. Among the 47 recipients, 35 received kidneys from living related donors and 12 from deceased donors. The mean renal artery blood flow was 450.74 ml/min (median=425) and the mean renal vein flow was 541.49 ml/min (median=470). With multivariate regression on creatinine declining ratio, graft arterial blood flow has significant impact on day 2 and 3 while graft venous blood flow was significant on day 1, 2, 3, 7 and 30 (p<0.05). As for urine output, graft arterial flow was significantly associated with more urine output on day 0-1 and day 0-2 but not any further after day 3. Graft venous flow had no impact on urine amount postoperatively. Conclusion: Graft arterial blood flow was significantly associated with creatinine declining ratio and urine output amount whilst graft venous blood flow showed more persistent association with creatinine declining ratio during early postoperative phase.