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Malik MS, Akoh JA, Houlberg K. The Use of the Implantable Doppler Probe as a Blood Flow Monitoring Device in Clinical Settings: A Narrative Review of the Evidence. EXP CLIN TRANSPLANT 2023; 21:83-92. [PMID: 36919717 DOI: 10.6002/ect.2022.0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
OBJECTIVES In the past decade, the implantable Doppler probe has been studied widely as a blood flow-monitoring device in reconstructive and transplant surgical specialities. Its utility as an effective postoperative monitoring technique is still debatable, with no clear guidelines in clinical practice. Here, we mapped the current evidence on the usefulness of the implantable Doppler probe as a blood flow-monitoring device. The objective was to present an up-to-date assessment of the benefits and limitations of using implantable Doppler probes in clinical and experimental clinical settings. MATERIALS AND METHODS We conducted a literature search using the Cochrane Library and Healthcare Databases Advanced Search and using implantable Doppler probe, transplant, graft, and flap as key words. The search yielded 184 studies, with 73 studies included after exclusions. We evaluated, synthesized, and summarized the evidence from the studies in tabular form. RESULTS There is clinical equipoise regarding the effectiveness of implantable Doppler probe as a flow sensing technique. The main reason is the lack of information and gaps in the evidence regarding the benefits and limitations of using implantable Doppler probes in clinical practice. CONCLUSIONS The implantable Doppler probe has the potentialto be used as an adjunctpostoperativeblood flow-monitoring device. However, keeping in view of technical limitations, its signals should be interpreted alongside traditional clinical assessment techniques to determine the patency of microvascular anastomosis. Although evidence in this review will inform clinical practice in transplant and reconstructive surgical specialties, a prospective randomized controlled study with a larger patient cohort is required to evaluate the effectiveness of this probe in clinical settings.
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Lu D, Li S, Yang Q, Arafa HM, Xu Y, Yan Y, Ostojich D, Bai W, Guo H, Wu C, Li S, Jacobson L, Westman AM, MacEwan MR, Huang Y, Pet M, Rogers JA. Implantable, wireless, self-fixing thermal sensors for continuous measurements of microvascular blood flow in flaps and organ grafts. Biosens Bioelectron 2022; 206:114145. [DOI: 10.1016/j.bios.2022.114145] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/09/2022] [Accepted: 02/28/2022] [Indexed: 11/02/2022]
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Zhu XH, Han LX, Zhang RJ, Zhang P, Chen FG, Yu J, Luo H, Han XW. The functional activity of donor kidneys is negatively regulated by microribonucleic acid-451 in different perfusion methods to inhibit adenosine triphosphate metabolism and the proliferation of HK2 cells. Bioengineered 2022; 13:12706-12717. [PMID: 35603466 PMCID: PMC9275911 DOI: 10.1080/21655979.2022.2068739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
This study explored the regulation of different perfusion methods on ischemia-reperfusion injury in donor kidneys. In this study, renal cortical/medullary tissue specimens were collected from porcine kidneys donors using different perfusion methods at various time points. Hematoxylin and eosin (H&E) staining was used to test the histological differences. Differentially expressed micro-ribonucleic acids (miRNAs) were identified by miRNA transcriptome sequencing. Reverse transcription-polymerase chain reaction (RT-PCR) tests were used to verify the changes in miRNAs in the kidney tissue taken from different perfusion groups. The related signaling pathways and the changes in the cell functions of different perfusion groups were analyzed by Kyoto Encyclopedia of Genes and Genomes (KEGG) /Gene Ontology (GO) bioinformatics analyses. The effects of miRNA overexpression on the metabolism and proliferation of HK2 cells were detected by ATP kit and MTT assay. The H&E staining results showed that there were essentially no differences in the tissue samples among different perfusion groups at and before 12 h compared with a control group. The quantitative PCR results revealed that there was essentially no change in the expression of ssc-miR-451, ssc-miR-1285, and ssc-miR-486 in the cis infusion or joint infusion kidney groups, and their expression was significantly down-regulated over time in the trans-infusion kidney group. The bioinformatics analysis showed that the cellular component, molecular function, and biological processes of the kidney tissue, which had been perfused using three methods, had been consistently affected. The most significant changes after perfusion occurred in the intracellular metabolism signaling pathways. Furthermore, the energy metabolism and proliferation of the HK2 cells were significantly inhibited after the overexpression of miR-451. Specific miRNA markers, such as miR-451, may play a negative regulatory role in cell metabolism following the perfusion of kidney transplants using different methods.
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Affiliation(s)
- Xu-Hui Zhu
- Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, PR China
| | - Long-Xi Han
- Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, PR China
| | - Rong-Jie Zhang
- Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, PR China
| | - Peng Zhang
- Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, PR China
| | - Fu-Gang Chen
- Department of General Surgery, Guizhou Provincial Staff Hospital, Guiyang PR China
| | - Jia Yu
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guiyang PR China
- The Key Laboratory of Chemistry for Natural Products, Guizhou Province and Chinese Academy of Science, Guiyang PR China
| | - Heng Luo
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guiyang PR China
- The Key Laboratory of Chemistry for Natural Products, Guizhou Province and Chinese Academy of Science, Guiyang PR China
| | - Xiu-Wu Han
- Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, PR China
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Maly S, Janousek L, Bortel R, Sebek J, Hospodka J, Skapa J, Fronek J. NIRS-based monitoring of kidney graft perfusion. PLoS One 2020; 15:e0243154. [PMID: 33264371 PMCID: PMC7710057 DOI: 10.1371/journal.pone.0243154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/16/2020] [Indexed: 12/28/2022] Open
Abstract
Introduction Acute early vascular complications are rare, but serious complications after kidney transplantation. They often result in graft loss. For this reason, shortening the diagnostic process is crucial. Currently, it is standard procedure to monitor renal graft perfusion using Doppler ultrasound (DU). With respect to acute vascular complications, the main disadvantage of this type of examination is its periodicity. It would be of great benefit if graft blood perfusion could be monitored continuously during the early postoperative period. It appears evident that a well-designed near infrared spectroscopy (NIRS) monitoring system could prove very useful during the early post-transplantation period. Its role in the immediate diagnosis of vascular complications could result in a significant increase in graft salvage, thus improving the patient’s overall quality of life and lowering morbidity and mortality for renal graft recipients. The aim of this study was to design, construct and test such a monitoring system. Materials and methods We designed a rough NIRS-based system prototype and prepared a two-stage laboratory experiment based on a laboratory pig model. In the first stage, a total of 10 animals were used to verify and optimize the technical aspects and functionality of the prototype sensor by testing it on the animal kidneys in-vivo. As a result of these tests, a more specific prototype was designed. During the second stage, we prepared a unique laboratory model of a pig kidney autotransplantation and tested the system for long-term functionality on a group of 20 animals. Overall sensitivity and specificity were calculated, and a final prototype was prepared and completed with its own analytic software and chassis. Results We designed and constructed a NIRS-based system for kidney graft perfusion monitoring. The measurement system provided reliable performance and 100% sensitivity when detecting acute diminished blood perfusion of the transplanted kidneys in laboratory conditions. Conclusion The system appears to be a useful tool for diagnosing diminished blood perfusion of kidney transplants during the early postoperative period. However, further testing is still required. We believe that applying our method in current human transplantation medicine is feasible, and we are confident that our prototype is ready for human testing.
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Affiliation(s)
- Stepan Maly
- Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
- * E-mail:
| | - Libor Janousek
- Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Radoslav Bortel
- Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Jan Sebek
- Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Jiri Hospodka
- Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Jiri Skapa
- Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Jiri Fronek
- Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- Department of Anatomy, Second Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
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Shen Z, Yu Q, Li Y, Bao Y, Lu H. Determination of acyclovir in renal microdialysis fluid and confirmation of renal function index. Drug Chem Toxicol 2018; 43:574-580. [PMID: 30486699 DOI: 10.1080/01480545.2018.1524474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Acyclovir (ACV) is a nucleoside antivirus-free agent that was developed and marketed by Burroughs Well-come of the United States. Renal damage from ACV has been a major factor limiting its clinical application. Thus, the renal toxicity mechanism of ACV requires systematic study. In our previous study, we speculated that the nephrotoxicity of ACV may be associated with oxidative stress. In addition to the study of ACV's toxic effect in vivo, it is also necessary to explore the absorption and distribution of ACV in the body to further investigate the changes to ACV in the body. In this study, the toxicokinetics ACV in the kidney of the rat were explored using microdialysis, and the renal function of rats was measured. The results showed that high-dose ACV is associated with renal toxicity after a single intravenous injection or successive administration.
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Affiliation(s)
- ZheLun Shen
- School of Pharmacology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, PR China
| | - QingQing Yu
- School of Pharmacology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, PR China
| | - YangLei Li
- School of Pharmacology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, PR China
| | - YiQi Bao
- School of Pharmacology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, PR China
| | - Hong Lu
- School of Pharmacology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, PR China
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Wallenius K, Thalén P, Björkman JA, Johannesson P, Wiseman J, Böttcher G, Fjellström O, Oakes ND. Involvement of the metabolic sensor GPR81 in cardiovascular control. JCI Insight 2017; 2:92564. [PMID: 28978803 DOI: 10.1172/jci.insight.92564] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 08/24/2017] [Indexed: 12/21/2022] Open
Abstract
GPR81 is a receptor for the metabolic intermediate lactate with an established role in regulating adipocyte lipolysis. Potentially novel GPR81 agonists were identified that suppressed fasting plasma free fatty acid levels in rodents and in addition improved insulin sensitivity in mouse models of insulin resistance and diabetes. Unexpectedly, the agonists simultaneously induced hypertension in rodents, including wild-type, but not GPR81-deficient mice. Detailed cardiovascular studies in anesthetized dogs showed that the pressor effect was associated with heterogenous effects on vascular resistance among the measured tissues: increasing in the kidney while remaining unchanged in hindlimb and heart. Studies in rats revealed that the pressor effect could be blocked, and the renal resistance effect at least partially blocked, with pharmacological antagonism of endothelin receptors. In situ hybridization localized GPR81 to the microcirculation, notably afferent arterioles of the kidney. In conclusion, these results provide evidence for a potentially novel role of GPR81 agonism in blood pressure control and regulation of renal vascular resistance including modulation of a known vasoeffector mechanism, the endothelin system. In addition, support is provided for the concept of fatty acid lowering as a means of improving insulin sensitivity.
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