Renal cortex microperfusion evaluated by laser speckle contrast imaging in an ex vivo perfused kidney model—A proof‐of‐concept study

Background Validated quantitative biomarkers for assessment of renal graft function during normothermic machine perfusion (NMP) conditions are lacking. The aim of this project was to quantify cortex microperfusion during ex vivo kidney perfusion using laser speckle contrast imaging (LSCI), and to ev...

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Published in:Artificial organs 2024-04, Vol.48 (4), p.347-355
Main Authors: Arildsen, Maibritt Meldgaard, Thrane, Lars, Staulund, Jesper, Eijken, Marco, Jespersen, Bente, Postnov, Dmitry, Al‐Mashhadi, Rozh H., Pedersen, Michael
Format: Article
Language:English
Subjects:
Animals
Biomarkers
Blood flow
Blood Flow Velocity
Damage
Evaluation
Exposure
Feasibility studies
Ischemia
Kidney - blood supply
Kidney Transplantation
Kidneys
Laser Speckle Contrast Imaging
Microspheres
Neuroimaging
Perfusion
porcine
Renal Circulation
Renal cortex
renal cortex microperfusion
Renal function
Sensitivity analysis
Swine
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Summary:Background Validated quantitative biomarkers for assessment of renal graft function during normothermic machine perfusion (NMP) conditions are lacking. The aim of this project was to quantify cortex microperfusion during ex vivo kidney perfusion using laser speckle contrast imaging (LSCI), and to evaluate the sensitivity of LSCI when measuring different levels of renal perfusion. Furthermore, we aimed to introduce LSCI measurements during NMP in differentially damaged kidneys. Methods Eleven porcine kidneys were nephrectomized and perfused ex vivo. Cortex microperfusion was simultaneously monitored using LSCI. First, a flow experiment examined the relationship between changes in delivered renal flow and corresponding changes in LSCI‐derived cortex microperfusion. Second, renal cortical perfusion was reduced stepwise by introducing a microembolization model. Finally, LSCI was applied for measuring renal cortex microperfusion in kidneys exposed to minimal damage or 2 h warm ischemia (WI). Results Cortex microperfusion was calculated from the LSCI‐obtained data. The flow experiment resulted in relatively minor changes in cortex microperfusion compared to the pump‐induced changes in total renal flow. Based on stepwise injections of microspheres, we observed different levels of cortex microperfusion that correlated with administrated microsphere dosages (r2 = 0.95–0.99). We found no difference in LSCI measured cortex microperfusion between the kidneys exposed to minimal damage (renal cortex blood flow index, rcBFI = 2090–2600) and 2 h WI (rcBFI = 2189–2540). Conclusions Based on this preliminary study, we demonstrated the feasibility of LSCI in quantifying cortex microperfusion during ex vivo perfusion. Furthermore, based on LSCI‐measurements, cortical microperfusion was similar in kidneys exposed to minimal and 2 h WI. The aim of this project was to quantify cortex microperfusion during ex vivo kidney perfusion using laser speckle contrast imaging (LSCI), and to evaluate the sensitivity of LSCI when measuring different levels of renal perfusion. Furthermore, we aimed to introduce LSCI measurements during NMP in differentially damaged kidneys. Using LSCI it is feasible to quantify different levels of renal cortex microperfusionin porcine kidneys completely non‐invasively during ex vivo perfusion. Although further investigation is needed, LSCI is a promising technique for future pre‐transplant assessment of kidney viability during normothermic machine perfusion.
ISSN:0160-564X
1525-1594
DOI:10.1111/aor.14675