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 StefańczykADEDOI: 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
972 56
In Press
17 May 2023 : Original article
Results of Liver Retransplantation After Rescue Hepatectomy: A Single-Center StudyAnn Transplant In Press; DOI: 10.12659/AOT.939557
10 May 2023 : Original article
Incidence of Thromboembolic Complications Following Kidney Transplantation with Short and Extended Aspirin ...Ann Transplant In Press; DOI: 10.12659/AOT.939143
Most Viewed Current Articles
24 Aug 2021 : Review article
Normothermic Machine Perfusion (NMP) of the Liver – Current Status and Future PerspectivesDOI :10.12659/AOT.931664
Ann Transplant 2021; 26:e931664
26 Jan 2022 : Review article
Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive ModelsDOI :10.12659/AOT.934924
Ann Transplant 2022; 27:e934924
29 Dec 2021 : Original article
Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...DOI :10.12659/AOT.933588
Ann Transplant 2021; 26:e933588
15 Mar 2022 : Case report
Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...DOI :10.12659/AOT.935860
Ann Transplant 2022; 27:e935860