Introduction
Kidney transplantation (KT) has become the treatment of choice for
paediatric end-stage renal disease [1]. Nevertheless, in comparison
to adults, the small caliber of the vessels and the common size-mismatch
between donors and recipients can predispose to vascular complications
including allograft thrombosis. The latter may affect up to 10% of KTs
and account for 35% of allograft losses in the first year [2].
Prompt recognition and treatment is clearly essential for the
preservation of the allograft.
Vascular complications have no specific clinical or biochemical signs
allowing for early diagnosis. Doppler-ultrasonography (DUS) and renal
scintigraphy are reliable tools to assess allograft perfusion [3],
but do not allow for continuous monitoring of the allograft and can miss
early diagnosis, even if performed with a strict schedule in early
follow-up of KT [4].
Transcutaneous near-infrared spectroscopy (NIRS) allows for
non-invasive, real-time, continuous monitoring of regional oxygenation
of the haemoglobin (rSrO2), which is an indirect measure of the blood
flow and the metabolic state, of tissue placed deeper beyond the skin.
Several clinical studies have tested the use of NIRS for monitoring
cerebral and somatic perfusion in intensive care units [5] and the
viability of soft-tissue flaps [6]. Recently, it has been proposed
for the surveillance of allograft perfusion too [7].
A systematic search of literature was performed, aiming to identify the
current evidence on the in vivo application of NIRS for the
monitoring of allograft perfusion. The findings might be useful for
future research to implement the large-scale use of NIRS.