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This study aimed to evaluate HSI as a predictive tool for early postoperative graft function and long-term outcomes in living donor (LD) and deceased donor (DD) kidney transplantation (KT).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients and methods<\/jats:title>\n            <jats:p>HSI of kidney allograft parenchyma from 19 LD and 51 DD kidneys was obtained intraoperatively 15 minutes after reperfusion. Using the dedicated HSI TIVITA Tissue System, indices of tissue oxygenation (StO<jats:sub>2<\/jats:sub>), perfusion (near-infrared [NIR]), organ hemoglobin (OHI), and tissue water (TWI) were calculated and then analyzed retrospectively.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>LD kidneys had superior intraoperative HSI values of StO<jats:sub>2<\/jats:sub> (0.78 \u00b1 0.13 versus 0.63 \u00b1 0.24; <jats:italic>P<\/jats:italic>\u2009=\u20090.001) and NIR (0.67 \u00b1 0.10 versus 0.56 \u00b1 0.27; <jats:italic>P<\/jats:italic>\u2009=\u20090.016) compared to DD kidneys. Delayed graft function (DGF) was observed in 18 cases (26%), in which intraoperative HSI showed significantly lower values of StO<jats:sub>2<\/jats:sub> (0.78 \u00b1 0.07 versus 0.35 \u00b1 0.21; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and NIR (0.67 \u00b1 0.11 versus 0.34 \u00b1 0.32; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Receiver operating characteristic curve analysis demonstrated an excellent predictive value of HSI for the development of DGF, with an area under the curve of 0.967 for StO<jats:sub>2<\/jats:sub> and 0.801 for NIR. Kidney grafts with low StO<jats:sub>2<\/jats:sub> values (cut-off point 0.6) showed reduced renal function with a low glomerular filtration rate and elevated urea levels in the first two weeks after KT. Three years after KT, graft survival was also inferior in the group with initially low StO<jats:sub>2<\/jats:sub> values.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>HSI is a useful tool for predicting DGF in living and deceased KT and may assist in estimating short-term allograft function. However, further studies with expanded cohorts are needed to evaluate the association between HSI and long-term graft outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12880-025-01576-6","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T16:13:11Z","timestamp":1738339991000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hyperspectral imaging in living and deceased donor kidney transplantation"],"prefix":"10.1186","volume":"25","author":[{"given":"Rasmus","family":"Wrigge","sequence":"first","affiliation":[]},{"given":"Robert","family":"Sucher","sequence":"additional","affiliation":[]},{"given":"Fabian","family":"Haak","sequence":"additional","affiliation":[]},{"given":"Hans-Jonas","family":"Meyer","sequence":"additional","affiliation":[]},{"given":"Julia","family":"Unruh","sequence":"additional","affiliation":[]},{"given":"Hans-Michael","family":"Hau","sequence":"additional","affiliation":[]},{"given":"Matthias","family":"Mehdorn","sequence":"additional","affiliation":[]},{"given":"Hans-Michael","family":"Tautenhahn","sequence":"additional","affiliation":[]},{"given":"Daniel","family":"Seehofer","sequence":"additional","affiliation":[]},{"given":"Uwe","family":"Scheuermann","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2025,1,31]]},"reference":[{"issue":"2","key":"1576_CR1","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1097\/TP.0b013e3181ac620b","volume":"88","author":"PS Rao","year":"2009","unstructured":"Rao PS, Schaubel DE, Guidinger MK, Andreoni KA, Wolfe RA, Merion RM, Port FK, Sung RS. 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Written informed consent from any patient for data collection in a prospectively collected data base is available. However, written informed consent to the study was waived by the local Ethics Committee (Ethics Committee of the first affiliated University Hospital of Leipzig University) in view of the retrospective design of the study, accordingly the national and local guidelines such as the fact that all clinical\/ laboratory measurements and procedures were part of the routine care.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"34"}}