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...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-08-01
|
| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.697055/full |
| _version_ | 1831587364058693632 |
|---|---|
| author | Laila-Yasmin Mani Maryam Seif Maryam Seif Florence Nikles Dechen W. Tshering Vogel Gaëlle Diserens Petros Martirosian Michel Burnier Bruno Vogt Peter Vermathen |
| author_facet | Laila-Yasmin Mani Maryam Seif Maryam Seif Florence Nikles Dechen W. Tshering Vogel Gaëlle Diserens Petros Martirosian Michel Burnier Bruno Vogt Peter Vermathen |
| author_sort | Laila-Yasmin Mani |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-17T21:53:36Z |
| format | Article |
| id | doaj.art-5f549780d57b4e1f911ac65d203e9916 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-17T21:53:36Z |
| publishDate | 2021-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-5f549780d57b4e1f911ac65d203e99162022-12-21T21:31:11ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-08-01810.3389/fmed.2021.697055697055Hip Position Acutely Affects Oxygenation and Perfusion of Kidney Grafts as Measured by Functional Magnetic Resonance Imaging Methods—The Bent Knee StudyLaila-Yasmin Mani0Maryam Seif1Maryam Seif2Florence Nikles3Dechen W. Tshering Vogel4Gaëlle Diserens5Petros Martirosian6Michel Burnier7Bruno Vogt8Peter Vermathen9Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartments of Biomedical Research and Radiology, University of Bern, Bern, SwitzerlandSpinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, SwitzerlandDepartments of Biomedical Research and Radiology, University of Bern, Bern, SwitzerlandDepartment of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartments of Biomedical Research and Radiology, University of Bern, Bern, SwitzerlandSection on Experimental Radiology, University of Tübingen, Tübingen, GermanyService of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital, Lausanne, SwitzerlandDepartment of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartments of Biomedical Research and Radiology, University of Bern, Bern, SwitzerlandBackground: 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.https://www.frontiersin.org/articles/10.3389/fmed.2021.697055/fullhip flexionkidney transplantationperfusionoxygenationfunctional MRIBOLD |
| spellingShingle | Laila-Yasmin Mani Maryam Seif Maryam Seif Florence Nikles Dechen W. Tshering Vogel Gaëlle Diserens Petros Martirosian Michel Burnier Bruno Vogt Peter Vermathen Hip Position Acutely Affects Oxygenation and Perfusion of Kidney Grafts as Measured by Functional Magnetic Resonance Imaging Methods—The Bent Knee Study Frontiers in Medicine hip flexion kidney transplantation perfusion oxygenation functional MRI BOLD |
| 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 | hip flexion kidney transplantation perfusion oxygenation functional MRI BOLD |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.697055/full |
| work_keys_str_mv | AT lailayasminmani hippositionacutelyaffectsoxygenationandperfusionofkidneygraftsasmeasuredbyfunctionalmagneticresonanceimagingmethodsthebentkneestudy AT maryamseif hippositionacutelyaffectsoxygenationandperfusionofkidneygraftsasmeasuredbyfunctionalmagneticresonanceimagingmethodsthebentkneestudy AT maryamseif hippositionacutelyaffectsoxygenationandperfusionofkidneygraftsasmeasuredbyfunctionalmagneticresonanceimagingmethodsthebentkneestudy AT florencenikles hippositionacutelyaffectsoxygenationandperfusionofkidneygraftsasmeasuredbyfunctionalmagneticresonanceimagingmethodsthebentkneestudy AT dechenwtsheringvogel hippositionacutelyaffectsoxygenationandperfusionofkidneygraftsasmeasuredbyfunctionalmagneticresonanceimagingmethodsthebentkneestudy AT gaellediserens hippositionacutelyaffectsoxygenationandperfusionofkidneygraftsasmeasuredbyfunctionalmagneticresonanceimagingmethodsthebentkneestudy AT petrosmartirosian hippositionacutelyaffectsoxygenationandperfusionofkidneygraftsasmeasuredbyfunctionalmagneticresonanceimagingmethodsthebentkneestudy AT michelburnier hippositionacutelyaffectsoxygenationandperfusionofkidneygraftsasmeasuredbyfunctionalmagneticresonanceimagingmethodsthebentkneestudy AT brunovogt hippositionacutelyaffectsoxygenationandperfusionofkidneygraftsasmeasuredbyfunctionalmagneticresonanceimagingmethodsthebentkneestudy AT petervermathen hippositionacutelyaffectsoxygenationandperfusionofkidneygraftsasmeasuredbyfunctionalmagneticresonanceimagingmethodsthebentkneestudy |