MUHAMMAD SHAHZAR MALIK, ZAIN UL ABIDEEN, KRIS HOULBERG, JACOB A AKOH
Experimental and Clinical Transplantation - 2024;22(10):731-744
Objectives: The implantable Doppler probe can monitor the patency of vascular anastomosis, thereby facilitating early detection of vascular thrombosis critical to reducing graft loss. In this study, we examined the effectiveness of this technology compared with standard clinical care in reducing thrombosis-related graft loss and the requirement for color duplex ultrasonography in the first 24 hours postoperatively by a medical literature search of the application of this technology in kidney transplantation. Materials and Methods: We conducted a systematic search (January 15, 2024) of a wide range of experimental and observational studies that comprised kidney transplant recipients monitored with blood flow sensing technology (intervention group) and standard clinical care (control group). Primary outcomes were differences between groups of thrombosis-related graft loss and surveillance requirement of color duplex ultrasonography scans in the first 24 hours postoperatively. Two independent researchers conducted critical appraisal and data extraction of the selected papers using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. We used a random effects model for the meta-analysis. Dichotomous outcomes were expressed as relative risk or odds ratio. Results: The search identified 43 articles. After exclusion criteria, 7 studies (1 experimental, 6 observational) were included, with a total participant sample of 874 adult kidney transplant recipients with and without blood flow sensing technology. The certainty of evidence level was rated as moderate. Blood flow sensing technology resulted in a 66% reduction in the risk of thrombosis-related graft loss and a 61% lower probability of requiring color duplex ultrasonography in the first 24 hours postoperatively compared with standard clinical care. Conclusions: Blood flow sensing technology can be used as a helpful adjunct in the postoperative monitoring of kidney transplant recipients. However, given the technical limitations, signals should be interpreted alongside the traditional clinical assessment techniques.
