Disturbances of Kidney Graft Perfusion as Indicators of Acute Renal Vein Thrombosis in Contrast-Enhanced Ultrasonography

Grzelak, Piotr; Kurnatowska, Ilona; Sapieha, Michał; Strzelczyk, Janusz; Nowicki, Michał; Stefańczyk, Ludomir

doi:10.1016/j.transproceed.2011.08.067

Cited by 10 publications

(9 citation statements)

References 10 publications

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“…6 Therefore, in the early period posttransplant, together with clinical symptoms such as hematuria, oliguria, and hypotension, Doppler ultrasonographic findings of high resistance arterial flow with poor parenchymal perfusion can be used to consider renal vein thrombosis as an underlying reason of symptoms, and treatment should be done accordingly. Our patient, who presented with renal vein thrombosis due to acute humoral rejection, is unique regarding his graft gaining back its perfusion ability after a long interval of parenchymal necrosis, with restoration of graft to full function and size.…”

Section: Discussionmentioning

confidence: 99%

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Ozturk

Uslu²,

Akçay³

et al. 2017

Exp Clin Transplant

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A 47-year-old male patient underwent living-related renal transplant. On day 3 posttransplant, without evidence of associated clinical symptoms, the patient's serum creatinine levels had increased. The patient was given immunosuppressive medication, and a followup Doppler ultrasonography revealed hypoechoic areas in the inferior pole of the renal parenchyma. Eventually, on day 25, there was no perfusion in the superior and inferior poles of the transplanted kidney. No venous flow was shown in the middle segment, and only arterial vascularization with a high resistive index and negative diastolic phase was observed. Renal biopsy showed acute humoral rejection. This was interpreted as venous thrombosis secondary to acute humoral rejection. Tissue plasminogen activator infusion, plasmapheresis, and hemodialysis were administered. After 1.5 months, arterial flow returned to its normal pattern and the renal allograft recovered by gaining back its full vascularity at the end of month 8.

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Section: Discussionmentioning

confidence: 99%

Untitled

Ozturk

Uslu²,

Akçay³

et al. 2017

Exp Clin Transplant

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“…Each examination was carried out by the same experienced radiologist, who was aware of the type of arterial anastomosis and the presence of supernumerary arteries, but was unaware of other clinical data. All examinations had a common protocol that included dynamic acquisitions in the long and short axes of the grafts [2,4,11]. The area of acquisition encompassed the whole graft, and the examination was recorded in the scanner's memory.…”

Section: Methodsmentioning

confidence: 99%

“…Graft parenchyma perfusion disturbances (GPPD) have to be taken into consideration. Early detection of this pathological condition can enable correct treatment and thus influence early and long-term graft survival [1,2,3,4]. Monitoring graft function using biochemical parameters, glomerular filtration rate, or urine output is often not specific.…”

Section: Introductionmentioning

confidence: 99%

Perfusion Disturbances of Kidney Graft Parenchyma Evaluated with Contrast-Enhanced Ultrasonography in the Immediate Period following Kidney Transplantation

et al. 2013

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Purpose: Graft parenchyma perfusion disturbances (GPPD) in transplanted kidneys are common in the early postoperative period. Rapid and accurate diagnosis can guide proper treatment, preventing graft dysfunction. Methods: One hundred and eighty patients, who underwent kidney transplantation (KTx), were examined in the immediate postoperative period using real-time ultrasonography (B-mode) with color and power Doppler (US-CD/PD) and B-flow ultrasound, as well as with an additional protocol of contrast-enhanced ultrasonography (CE-US). Regions of GPPD were localized and measured. The number and size of these areas were compared between the two acquisition techniques. Follow-up examinations were carried out 6 months postoperatively. Results: CE-US revealed more GPPDs and showed them more precisely than the B+US-CD/PD/B-flow technique. Moreover, in the CE-US examination, ischemic foci had statistically significant higher echogenicity in comparison to normal parenchyma, were larger and better visualized (better circumscribed) than in B+US-CD/PD/B-flow. Conclusion: CE-US allows the visualization of GPPD caused by occlusion of small arteries. It is a noninvasive, safe, real-time method, which has many advantages over standard B+US-CD/PD/B-flow examinations, and we recommend it as a routine diagnostic procedure in the early postoperative period following KTx.

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“…One of the areas, in which contrast ultrasound is currently being used, is the monitoring of recently transplanted organs, including the kidneys [7–9]. …”

Section: Introductionmentioning

confidence: 99%

Standardowe badanie w prezentacji B oraz badanie z podaniem środka kontrastowego (US-CE) - porównanie przydatności badań ultrasonograficznych w ocenie echostruktury i wielkości krwiaków u pacjentów po przeszczepie nereki – wstępne doniesienia.

et al. 2012

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SummaryBackground:During routine ultrasonographic examination in B presentation, performed as a standard diagnostic procedure during the early post-operative period, the most important problem with the interpretation of the images of perirenal haematoma is their ability to change in time. The aim of this work was to assess the echogenicity and the size of perirenal haematomas in patients after kidney transplant during routine examinations in B presentation and during examinations enhanced with a contrast medium (CE-US).Material/Methods:Thirty-seven patients after kidney transplant were examined using standard examination in B presentation. Sixteen patients (7 women and 9 men) with isoechogenic and hypoechogenic areas visualized within the renal parenchyma, who were suspected of perirenal haematoma, underwent a CE-US examination after intravenous administration of sculpture hexafluoride (dose: 2.4 ml/examination). Using time-intensity curves (TIC), changes in the values were analysed for two areas of interest (ROI): in the renal parenchyma and in the areas identified during standard US as haematomas. Identical examination protocols and dynamic data loops allowed the acquisition of identical kidney cross-sections and enabled measuring the echogenicity and thickness of the abnormalities at the same location.Results:During the routine B presentation examination, the average difference between haematoma and the renal cortex was 5 dB. When performing US-CE examination, a significantly greater difference in echogenicity was observed and reached 31 dB. In six patients, the size of haematomas was comparable using both techniques, whereas in ten patients lesions visualized in B presentation were smaller than in the US-CE examination.Conclusions:The US-CE examination demonstrated a greater, statistically significant, difference in the echogenicity of perirenal haematomas compared to the routine examination in B presentation. This method enabled a more detailed assessment of the size of haematomas in the perirenal space that appeared during early post-operative period.

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Disturbances of Kidney Graft Perfusion as Indicators of Acute Renal Vein Thrombosis in Contrast-Enhanced Ultrasonography

Cited by 10 publications

References 10 publications

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Untitled

Perfusion Disturbances of Kidney Graft Parenchyma Evaluated with Contrast-Enhanced Ultrasonography in the Immediate Period following Kidney Transplantation

Standardowe badanie w prezentacji B oraz badanie z podaniem środka kontrastowego (US-CE) - porównanie przydatności badań ultrasonograficznych w ocenie echostruktury i wielkości krwiaków u pacjentów po przeszczepie nereki – wstępne doniesienia.

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