Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

26 April 2013

Detection of transplant renal artery stenosis in the early postoperative period with analysis of parenchymal perfusion with ultrasound contrast agent

Piotr GrzelakABDEF, Ilona KurnatowskaBDEF, Michał NowickiADE, Katarzyna MurasBDEF, Michał PodgórskiCDEF, Janusz StrzelczykADE, Ludomir StefańczykADE

DOI: 10.12659/AOT.883896

Ann Transplant 2013; 18:187-194

Abstract

BACKGROUND: Transplant renal artery stenosis (TRAS) is a serious vascular complication due to non-specific clinical manifestations, causing serious diagnostic difficulties. Contrast-enhanced ultrasound (CE-US) can complement standard sonographic examination in evaluation of TRAS.

MATERIAL AND METHODS: Standard ultrasound B presentation, extended with color Doppler assessment of the flow spectrum and CE-US, was carried out in the early postoperative period in a group of 180 patients who underwent kidney transplantation. In CE-US analysis, the maximum contrast agent perfusion to the cortex and renal pyramids was evaluated. In 15 patients with sonographically diagnosed TRAS, magnetic resonance angiography and computer tomography angiography were performed to confirm the diagnosis.

RESULTS: In patients with TRAS, significantly longer time of contrast agent (CE) inflow was observed in comparison to patients without perfusion disturbances (3.47 s vs. 1.5 s, p<0.000 for cortex; 6.01 vs. 2.09 s for pyramids, p<0.000). The rate of CE inflow was strongly positively correlated with severity of stenosis assessed on the basis of CTA/MRA examination (R=0.97 for cortex and 0.9 for pyramids; p<0.001). Six months after kidney transplantation, patients with a history of TRAS had significantly higher serum creatinine level than recipients with normal renal artery blood flow (1.76 mg/dL vs. 1.53 mg/dl, p<0.02). Estimated GFR was decreased to 35.9 ml/min vs. 46.5 ml/min, respectively (p<0.05).

CONCLUSIONS: Contrast-enhanced ultrasound allows for quick and non-invasive assessment of parenchymal kidney graft perfusion. It enables confirmation of TRAS diagnosis in the early postoperative period and helps assess the degree of stenosis.

Keywords: Kidney Transplantation, contrast-enhanced Doppler ultrasonography, Transplant renal artery stenosis

Add Comment 0 Comments

In Press

Original article  

Post-Donation Regret and Anxiety Among Family Living Liver Donors: The Mediating Roles of Family Relationsh...

Ann Transplant In Press; DOI: 10.12659/AOT.944176  

Original article  

Effect of the Organ Donation Quality System on Donation Activity of Warsaw Hospitals

Ann Transplant In Press; DOI: 10.12659/AOT.943520  

Original article  

Clonal Hematopoiesis-Associated Gene Mutations Affect Acute Graft-Versus-Host Disease After Hematopoietic S...

Ann Transplant In Press; DOI: 10.12659/AOT.943688  

Original article  

Impact of Recipient and Donor Body Mass Index on Survival Outcomes After Intestinal Transplantation: A Unit...

Ann Transplant In Press; DOI: 10.12659/AOT.943994  

Most Viewed Current Articles

05 Apr 2022 : Original article   12,201

Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation

DOI :10.12659/AOT.935604

Ann Transplant 2022; 27:e935604

22 Nov 2022 : Original article   8,720

Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...

DOI :10.12659/AOT.937988

Ann Transplant 2022; 27:e937988

12 Jan 2022 : Original article   8,640

Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...

DOI :10.12659/AOT.934738

Ann Transplant 2022; 27:e934738

15 Mar 2022 : Case report   6,496

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358