Transcutaneous Near Infra-Red Spectroscopy (NIRS) for monitoring paediatric renal allograft perfusion

Background: The use of transcutaneous near-infrared spectroscopy (NIRS) for the monitoring of the perfusion of renal allografts in paediatric population has been proposed in the last years. This device might detect early decrease in allograft oxygenation allowing prompt detection of vascular complications. Methods. A systematic review of literature about the use of transcutaneous NIRS in monitoring allograft perfusion was performed according to the PRISMA guidelines. Results. The authors screened 1313 papers. The search yielded five pertinent articles. Three of them reported the experience of NIRS in kidney transplantation, for a total of 53 paediatric patients and 50 adults. In these studies, NIRS measurements was significantly related to serum creatinine, estimated glomerular filtration rate (eGFR), urinary neutrophil gelatinase-associated lipocalin (u-NGAL), serum lactate, resistive index assessed by doppler-ultrasonography and systolic blood pressure. In the paediatric studies no vascular complications were encountered. Conclusions. Preliminary studies have related NIRS monitoring to renal allograft perfusion and function. Further investigation is needed to establish the normal range of NIRS values for renal allografts and the factors influencing NIRS monitoring.