研究目的
To investigate whether there is an association between intraoperative microperfusion assessed by ICG fluorescence angiography and histopathological findings in native kidney biopsy specimens, and to compare it with duplex sonography as a reference method.
研究成果
Quantitative ICG fluorescence angiography reflects preexisting morphological changes in the renal cortex and shows a significant inverse correlation with chronicity scores and IFTA scores. It may serve as an objective alternative to duplex sonography for assessing microperfusion in kidney transplantation, with potential for predicting graft function, though this requires further investigation.
研究不足
The study was limited to two centers and a specific patient cohort; the correlation was significant only for the upper pole of the kidney, not the lower pole, possibly due to variations in vessel supply or sonography subjectivity. Further studies are needed to validate predictive value for graft function.
1：Experimental Design and Method Selection:
A prospective study design was used to correlate intraoperative microperfusion with histopathological findings. ICG fluorescence angiography with the SPY Elite System and duplex sonography were employed for perfusion assessment, and kidney biopsies were graded using the chronicity score.
2：Sample Selection and Data Sources:
77 patients with end-stage renal disease undergoing kidney transplantation at two university hospitals (Erlangen and Mannheim) were included. Inclusion criteria were absence of allergic diathesis or iodine allergy.
3：List of Experimental Equipment and Materials:
SPY Elite System (NOVADAQ, Canada) for ICG fluorescence angiography, ICG dye (ICG-Pulsion Medical Systems, Germany or Verdye, Diagnostic Green, Belgium), duplex sonography equipment, and standard surgical and biopsy tools.
4：Experimental Procedures and Operational Workflow:
After vascular anastomosis, ICG was injected intravenously, and fluorescence angiography was performed for 138 seconds. Duplex sonography was used to measure resistance indices (RI) on the kidney surface. Kidney biopsies were taken during ex-vivo preparation and graded by pathologists.
5：Data Analysis Methods:
Quantitative analysis of fluorescence videos was done using SPY-Q software to calculate ingress (IN) and ingress rate (InR). Statistical analysis used Pearson's correlation coefficient, Mann-Whitney U test, and Benjamini-Hochberg correction with R V 3.4.3 and SPSS 21.
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