Using the Speckle Doppler to Quantify Perfusion Quality in Kidney and Pancreas Grafts on Vascular Reperfusion
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 8
- 试验地点
- 1
- 主要终点
- To evaluate the use of the laser blood flow imager in both kidney and pancreas transplantation
研究概览
简要总结
Kidney and Pancreas transplantation is considered the treatment of choice for many people with End Stage Renal Disease and Type 1 diabetes because quality of life and survival is often better after transplantation. However the quality of organs varies as does the quality of perfusion once they are transplanted. The immediate determinant of the survival of any transplanted allograft often depends on the overall quality of perfusion of the organ. The assessment of perfusion is currently visually and empirically done and reported by the surgical team, with low objectivity. The Laser Speckle Doppler technique will be used in both kidney and pancreas transplantation to objectively study the quality of blood flow to the kidney and pancreas after transplantation. This Doppler will provide continuous, non-invasive blood flow monitoring of the microvascular environment of the transplanted organ. The strength of the technique is in evaluating changes in flow over an area of interest or the whole transplanted organ and accurately numerically quantifying the flow. The laser speckle Doppler technique is now well established and has been used in various clinical and research setting as the most convenient means of assessing tissue blood flow. It has however not yet been used in kidney and pancreas transplantation.
详细描述
BACKGROUND After reperfusion in solid organ transplantation, the quality of organ reperfusion is often assessed visually and reported as good, moderate, reasonable, patchy or poor. In our centre a Renogram is usually performed which uses radioactive tracer which most kidney transplant recipients would have within 24 hours after transplantation to assess the overall perfusion of the allograft. The Speckle Laser Doppler is a powerful clinical tool to obtain full field, high resolution images of microvascular perfusion of an organ It has been used in many medical fields such as dermatology vascular medicine and neurosciences both in a research and in clinical settings. This study seeks to utilise this technique to try to accurately quantify perfusion in the kidney and pancreas after transplantation and to develop a robust numerical quantification system of reporting on organ perfusion.
The Speckle Laser Doppler blood flow imager uses the laser speckle contrast technique to deliver real-time blood flow images with numerical physical data, providing outstanding performance in a wide range of pre-clinical and clinical research applications. This technique has not yet been applied for the assessment of kidney transplant perfusion reporting.
RESEARCH QUESTION/AIM(S)
- To evaluate the use of the laser blood flow imager in both kidney and pancreas transplantation and obtain real time video images with physical parametric data of the blood flow of transplanted organs at the time of transplantation as a proof of principle study to accurately quantify the blood flow rate either in the whole transplanted organ or a specific area of interest so as to develop a robust numerical quantification system of reporting on the perfusion of the transplanted organ. While this technique has been used in neurosurgery and other clinical settings it has not been evaluated before in a transplant setting.
. 2. Measure the markers of inflammation (Hypo perfusion) and oxidative stress and attempt correlation with the quality of perfusion obtained.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Inclusion Criteria:
- •Kidney Transplant Recipients
- •Age between 18 and 75 years
- •English Speaking as no funding for translators available
- •Able to provide written informed consent
- •Receiving a kidney transplant at Manchester University NHS Foundation Trust
- •Pancreas Transplant Recipients
- •Age between 18 and 75 years
- •English Speaking as no funding for translators available
- •Able to provide written informed consent All individuals will be considered for inclusion in this study regardless of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex, and sexual orientation except where the study inclusion and exclusion criteria EXPLICITLY state otherwise.
排除标准
- •Exclusion criteria
- •Outside of stated age range. Aged 76+
结局指标
主要结局
To evaluate the use of the laser blood flow imager in both kidney and pancreas transplantation
时间窗: 3 months
Doppler imaging of kidneys and pancreas
次要结局
- Measure the markers of inflammation ng/ml Hypo perfusion and oxidative stress (ng/ml) and attempt correlation with the quality of perfusion obtained(6-12 months)