Intraoperative imaging of pancreas transplant allografts using indocyanine green with laser fluorescence
Edmund Q. Sanchez, MD, Srinath Chinnakotla, MD, Tariq Khan, MD, Dmitriy Nikitin, MD, Sugam Vasani, MD, Henry B. Randall, MD, Greg J. McKenna, MD, Richard Ruiz, MD, Nicholas Onaca, MD, Marlon F. Levy, MD, Robert M. Goldstein, MD, John C. Docherty, PhD, David K. Hurd, and Goran B. Klintmalm, MD, PhD
Vascular thrombosis is a cause of allograft loss after pancreas transplantation. We present the use of intraoperative fluorescence imaging with the SPY imaging device (Novadaq Technologies Inc, Toronto, Canada) in two pancreas transplants as a means to assess patency of the vascular anastomoses. Intravenous indocyanine green 2.5 mg/mL was fluoresced with the device to create the intraoperative video sequences, which were recorded. After 60-day follow-up, real-time SPY imaging on these two pancreas transplants did not demonstrate adverse effects on patients or the transplanted allografts. This method of vascular imaging could prove useful in improving short-term graft survival and possibly lowering the thrombosis rates seen with pancreas transplantation. Long-term correlation studies between intraoperative findings and graft survival must be performed to confirm the utility of this imaging method.
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