Hemoglobin oxygenation kinetics and secondary ischemia in renal transplantation

Transplantation
N J LaneC J Green

Abstract

The significance of poor medullary reperfusion in the etiology of acute tubular necrosis during renal transplantation is poorly understood. Our objective was to determine the kinetics of renal hemoglobin oxygenation using near-infrared spectroscopy during renal transplantation, to provide a framework against which the timing of mitochondrial dysfunction could be considered. New Zealand White rabbit kidneys were flushed with hypertonic citrate solution (0-2 degrees C and autografted immediately (group 1) or stored at 0-2 degrees C for 72 hours before autografting (group 2). Changes in oxyhemoglobin (HbO2) and deoxyhemoglobin (Hb) were monitored by near-infrared spectroscopy for 3 hours of reperfusion. Intrarenal perfusion was evaluated separately by barium sulfate angiography. Reperfusion resulted in rapid increases in HbO2 within 1 minute in both groups. Group 1 HbO2 fell sharply to a minimum at 3 minutes but recovered by 20 minutes; group 2 changes were similar, but there was no recovery (P<0.05 by 10 minutes). Hb increased rapidly in both groups upon reperfusion but in group 2 was significantly greater after 10 minutes (P<0.05). Total hemoglobin levels were similar in both groups. Renal hemoglobin saturation was 69% at 1 minu...Continue Reading

References

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Citations

May 5, 1999·Liver Transplantation and Surgery : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·A E El-DesokyB Davidson
Aug 4, 2006·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Anna Petrova, Rajeev Mehta
Jun 29, 1997·Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences·M S ThornileyC J Green
Apr 27, 2012·Transplant International : Official Journal of the European Society for Organ Transplantation·Sanjeev KanoriaAlexander M Seifalian
Jul 16, 2014·PloS One·Tony J AklGerard L Coté
Jul 17, 1998·British Journal of Plastic Surgery·M S ThornileyC J Green

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