[Indocyanine green fluorescence to visualize the ureteric vascularization of kidney transplants: An exploratory study]. / Visualiser la vascularisation urétérale des transplants rénaux par fluorescence au vert d'indocyanine : étude exploratoire.

INTRODUCTION: Urinary complications after kidney transplantation are common and can compromise renal function. While they are mainly attributed to ischemic lesions of the ureter, there is no existing method to evaluate its vascularization during surgery. The aim of the study was to evaluate if indocyanine green, revealed by infra-red light andused to visualize tissue perfusion, could provide an appreciation of the ureter's vascularization during kidney transplantation. METHODS: This feasibility study was conducted over one month, on eleven consecutive kidney transplants. During transplantation, an injection of indocyanine green enabled the surgeon to visualize in real time with an infra-red camera the ureter fluorescence. Its intensity was reported on a qualitative and semi-quantitative scale. Occurrence of urinary complications such as stenosis or ureteral fistula were collected during 6 months. RESULTS: In all of the 11 cases (100%), the last centimeters of the ureters were not fluorescent. Three (27%) ureters were poorly or partiallly fluorescent. Out of these three cases, only one case of urinary fistula occurred, followed by ureteric stenosis. In the series, two fistulas (18%) and two ureteric stenoses (18%) occurred. No side effects were observed. The low number of events did not allow statistical analysis. CONCLUSION: Infra-red fluorescence of indocyanine green could be a simple and innovative way to appreciate the transplant's ureteric vascularization during kidney transplantation. It could help surgeons to identify the level of ureter section and to decide the anastomosis technique, in order to limit urinary complications. LEVEL OF EVIDENCE: 3.

["Imaging of diagnostic and therapeutic biomarkers in oncology" XIIIth edition of the workshop organised by the « Vectorisation, Imagerie, Radiothérapies ¼ network of the Cancéropôle Grand-Ouest, September 25-28, 2019, Le Bono, France]. / "Imaging of diagnostic and therapeutic biomarkers in oncology" XIIIe édition du workshop organisé par le réseau « Vectorisation, Imagerie, Radiothérapies ¼ du Cancéropôle Grand-Ouest, 25­28 septembre 2019, Le Bono, France.

The thirteenth edition of the workshop focused on the last developments on oncologic imaging techniques. Our goal was purposely large, consisting in bringing together chemists, biologists, physicists, pharmacists and physicians to discuss these imaging developments. The meeting focused in four main topics: i) the evolution of imaging modalities such as photoacoustic or the latest PET (positrons emission tomography) imaging progress; ii) the improvements in imaging process; iii) the numerous contributions of chemistry towards medical imaging and iv) novel approaches of nuclear medicine in therapeutic monitoring strategies and theranostic aspects.

Transposition of the great arteries: Rationale for tailored preoperative management.

As preoperative morbi-mortality remains significant, care of newborns with transposition of the great arteries is still challenging. In this review of the literature, we discuss the different treatments that could improve the patient's condition into the preoperative period. Instead of a standardized management, we advocate personalized care of these neonates. Considering the deleterious effects of hypoxia, special attention is given to the use of non-invasive technologies to assess oxygenation of the tissues. As a prolonged preoperative time with low cerebral oxygenation is associated with cerebral injuries, distinguishing neonates who should undergo early surgery from those who could wait longer is crucial and requires full expertise in the management of neonatal congenital heart disease. Finally, to treat these newborns as soon as possible, we support a planned delivery policy for foetuses with transposition of the great arteries.