Nephrology & Renal Care

Biography

Biography: Joseph Faraj

Abstract

Background

The arterial resistivity index [also called as Resistance index (RI) or Pourcelot Index], developed by Leandre Pourcelot, is a measure of pulsatile blood flow. Previous studies demonstrated the usefulness of RI as a predictor of allograft outcomes were based on RIs measured in the later stages after transplant.

Study Design

Retrospective cohort study of 305 renal transplants was reviewed, with analysis of their early RI measurements and its association with donor, recipient and surgical factors.

Setting & Participants

Adult kidney transplantation candidates carried out between 2003 and 2013

Predictor

Correlation between early RI and delayed graft failure (DGF) and transplant failure (TF).

Outcomes

To determine the relationship between immediate (24hr) RI measurements and renal allograft outcomes.

Measurements

All models were examined for goodness of fit using the test of Hosmer and Lemeshow. We also compared models based upon their concordance between observed TF and DGF values and the values predicted from the multivariate models using the area under the ROC curve (AUC).

Results

From a cohort of 305 patients who underwent renal transplants between 2003 and 2013. The mean recipient age was 48.4 years, 57.5% of recipients were male and approximately one third had diabetes. 226 recipients had a RI < 0.8, whilst only 27 patients had a RI ≥ 0.8. There was a significant association between a high RI (RI ≥ 0.8) and both outcomes (OR=3.54, p=0.008 for TF and OR= 3.22, p=0.006 for DGF).

Conclusions

An elevated resistive index was strongly a predictive of DGF and TF, when performed within 24 hours of time of transplantation.

Index Words:

End-stage renal disease (ESRD), Kidney transplantation, resistive index (RI), delayed graft function (DGF), transplant failure (TF).