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Hip Position Acutely Affects Oxygenation and Perfusion of Kidney Grafts as Measured by Functional Magnetic Resonance Imaging Methods—The Bent Knee Study

Background: Kidney perfusion and oxygenation are two important determinants of kidney graft function. In kidney transplantation, repeated graft hypoperfusion may occur during hip flexion, for example in the sitting position, due to the progressive development of fibrotic tissue around iliac arteries...

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Autores principales: Mani, Laila-Yasmin, Seif, Maryam, Nikles, Florence, Tshering Vogel, Dechen W., Diserens, Gaëlle, Martirosian, Petros, Burnier, Michel, Vogt, Bruno, Vermathen, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8384256/
https://www.ncbi.nlm.nih.gov/pubmed/34447762
http://dx.doi.org/10.3389/fmed.2021.697055
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author Mani, Laila-Yasmin
Seif, Maryam
Nikles, Florence
Tshering Vogel, Dechen W.
Diserens, Gaëlle
Martirosian, Petros
Burnier, Michel
Vogt, Bruno
Vermathen, Peter
author_facet Mani, Laila-Yasmin
Seif, Maryam
Nikles, Florence
Tshering Vogel, Dechen W.
Diserens, Gaëlle
Martirosian, Petros
Burnier, Michel
Vogt, Bruno
Vermathen, Peter
author_sort Mani, Laila-Yasmin
collection PubMed
description Background: Kidney perfusion and oxygenation are two important determinants of kidney graft function. In kidney transplantation, repeated graft hypoperfusion may occur during hip flexion, for example in the sitting position, due to the progressive development of fibrotic tissue around iliac arteries. The aim of this study was to assess the changes in oxygenation and perfusion of kidney grafts during hip flexion and extension using a new functional magnetic resonance imaging (fMRI) protocol. Methods: Nineteen kidney graft recipients prospectively underwent MRI on a 3T scanner including diffusion-weighted, blood oxygenation level dependent (BOLD), and arterial spin labeling sequences in hip positions 0° and >90° before and after intravenous administration of 20 mg furosemide. Results: Unexpectedly, graft perfusion values were significantly higher in flexed compared to neutral hip position. Main diffusion-derived parameters were not affected by hip position. BOLD-derived cortico-medullary R2(*) ratio was significantly modified during hip flexion suggesting an intrarenal redistribution of the oxygenation in favor of the medulla and to the detriment of the cortex. Furthermore, the increase in medullary oxygenation induced by furosemide was significantly blunted during hip flexion (p < 0.001). Conclusion: Hip flexion has an acute impact on perfusion and tissue oxygenation in kidney grafts. Whether these position-dependent changes affect the long-term function and outcome of kidney transplants needs further investigation.
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spelling pubmed-83842562021-08-25 Hip Position Acutely Affects Oxygenation and Perfusion of Kidney Grafts as Measured by Functional Magnetic Resonance Imaging Methods—The Bent Knee Study Mani, Laila-Yasmin Seif, Maryam Nikles, Florence Tshering Vogel, Dechen W. Diserens, Gaëlle Martirosian, Petros Burnier, Michel Vogt, Bruno Vermathen, Peter Front Med (Lausanne) Medicine Background: Kidney perfusion and oxygenation are two important determinants of kidney graft function. In kidney transplantation, repeated graft hypoperfusion may occur during hip flexion, for example in the sitting position, due to the progressive development of fibrotic tissue around iliac arteries. The aim of this study was to assess the changes in oxygenation and perfusion of kidney grafts during hip flexion and extension using a new functional magnetic resonance imaging (fMRI) protocol. Methods: Nineteen kidney graft recipients prospectively underwent MRI on a 3T scanner including diffusion-weighted, blood oxygenation level dependent (BOLD), and arterial spin labeling sequences in hip positions 0° and >90° before and after intravenous administration of 20 mg furosemide. Results: Unexpectedly, graft perfusion values were significantly higher in flexed compared to neutral hip position. Main diffusion-derived parameters were not affected by hip position. BOLD-derived cortico-medullary R2(*) ratio was significantly modified during hip flexion suggesting an intrarenal redistribution of the oxygenation in favor of the medulla and to the detriment of the cortex. Furthermore, the increase in medullary oxygenation induced by furosemide was significantly blunted during hip flexion (p < 0.001). Conclusion: Hip flexion has an acute impact on perfusion and tissue oxygenation in kidney grafts. Whether these position-dependent changes affect the long-term function and outcome of kidney transplants needs further investigation. Frontiers Media S.A. 2021-08-10 /pmc/articles/PMC8384256/ /pubmed/34447762 http://dx.doi.org/10.3389/fmed.2021.697055 Text en Copyright © 2021 Mani, Seif, Nikles, Tshering Vogel, Diserens, Martirosian, Burnier, Vogt and Vermathen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Mani, Laila-Yasmin
Seif, Maryam
Nikles, Florence
Tshering Vogel, Dechen W.
Diserens, Gaëlle
Martirosian, Petros
Burnier, Michel
Vogt, Bruno
Vermathen, Peter
Hip Position Acutely Affects Oxygenation and Perfusion of Kidney Grafts as Measured by Functional Magnetic Resonance Imaging Methods—The Bent Knee Study
title Hip Position Acutely Affects Oxygenation and Perfusion of Kidney Grafts as Measured by Functional Magnetic Resonance Imaging Methods—The Bent Knee Study
title_full Hip Position Acutely Affects Oxygenation and Perfusion of Kidney Grafts as Measured by Functional Magnetic Resonance Imaging Methods—The Bent Knee Study
title_fullStr Hip Position Acutely Affects Oxygenation and Perfusion of Kidney Grafts as Measured by Functional Magnetic Resonance Imaging Methods—The Bent Knee Study
title_full_unstemmed Hip Position Acutely Affects Oxygenation and Perfusion of Kidney Grafts as Measured by Functional Magnetic Resonance Imaging Methods—The Bent Knee Study
title_short Hip Position Acutely Affects Oxygenation and Perfusion of Kidney Grafts as Measured by Functional Magnetic Resonance Imaging Methods—The Bent Knee Study
title_sort hip position acutely affects oxygenation and perfusion of kidney grafts as measured by functional magnetic resonance imaging methods—the bent knee study
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8384256/
https://www.ncbi.nlm.nih.gov/pubmed/34447762
http://dx.doi.org/10.3389/fmed.2021.697055
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