Early Outcomes in Renal Transplantation With Routine Intraoperative Duplex Ultrasound.

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dc.contributorMy favourite contributor
dc.contributortest
dc.contributor.authorThebridge, Linda
dc.contributor.authorFisher, Charles
dc.contributor.authorPuttaswamy, Vikram
dc.contributor.authorPollock, Carol
dc.contributor.authorClarke, Jillian
dc.contributor.authorContributor 3
dc.contributor.congressMy Congress 2023-04-13
dc.date.accessioned2023-03-24T10:08:17Z
dc.date.available2023-03-24T10:08:17Z
dc.date.issued2023-03-21T00:00:00Z
dc.description.abstractWhile intra-operative duplex ultrasound scanning can be readily performed in renal transplantation, the value of this intervention in routine practice is not established.
dc.description.abstractThree hundred thirty-one consecutive single renal transplants in adult recipients underwent intraoperative scanning at implantation. Early graft losses were compared with those recorded in the ANZDATA Registry.
dc.description.abstractNine overt vascular abnormalities were corrected prior to scanning. Four further suspected venous outflow restrictions were confirmed by ultrasound and revised. Another 11 major vascular revisions were performed following intraoperative ultrasound consisting of 7 otherwise unsuspected inflow abnormalities, all corrected, and 4 anastomoses redone to reposition the graft. Thirty-two (9.7%) grafts were repositioned under ultrasound guidance to improve cortical perfusion but without vascular revision. One graft with hyperacute rejection was explanted 4 days postimplantation and one graft with primary nonfunction remained well perfused. Two patients died within 90 days, both with functioning grafts. Twenty-three grafts were re-explored within 7 days, including 9 solely for graft hypoperfusion. There were no postoperative arterial thromboses and, at re-exploration, no arterial anastomoses required revision. There were no postoperative venous thromboses, although one venous anastomosis was revised. No grafts were lost within 90 days for surgical or technical reasons compared with 76 (1.0%) of 7603 contemporaneous grafts in the ANZDATA Registry (P = .077 Fisher's exact test, P = .069 χ test).
dc.description.abstractThe routine use of intraoperative ultrasound appears to be of benefit by identifying otherwise unrecognized vascular abnormalities, leading to a reduction in early graft losses because of surgical factors.
dc.identifier.doi10.1016/j.transproceed.2023.02.055
dc.identifier.issn1873-2623
dc.identifier.other36959030
dc.identifier.piiS0041-1345(23)00109-4
dc.identifier.pmid36959030
dc.identifier.urihttps://internal.dspace7-test.dspace-express.com/handle/123456789/1160
dc.language.isoen
dc.rightsCopyright © 2023 Elsevier Inc. All rights reserved.
dc.source.countryUnited States
dc.source.journaltitleTransplantation proceedings
dc.subjectSubject1
dc.subjecttest
dc.subjectMy Subject
dc.subjectMy Subject 2023-04-13
dc.subject.engtest
dc.subject.meshMesh subject
dc.titleEarly Outcomes in Renal Transplantation With Routine Intraoperative Duplex Ultrasound.
dc.typeJournal Article
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