Emergency intra- and perioperative doppler after kidney transplantation—a guide for immediate surgical intervention

Ultrasonography in Vascular Diagnosis

“…Color duplex ultrasound should be routinely used after kidney transplant and can help to prevent graft loss by timely detection of early postoperative vascular complications Urbancic et al 2001). The sonographic parameters determined in this examination, in particular the resistance index (RI), also serve as baseline for subsequent follow-up examinations.…”

Farbkodierte Duplexsonografie nach Nierentransplantation

“…Compared with a retrospective control group in which 4 transplants were lost (13.3 %), no transplant loss occurred after the second operation in this study [23]. In a large series of 191 transplantations, intra-and post-operative Doppler sonography resulted in a reduction of transplant loss from 4.7 to 1.05 % [8].…”

“…Dabei erfolgt eine globale Beurteilung der Transplantatperfusion mit Bestimmung von Ausgangsmesswerten. Mittels frühpostoperativer Ultraschalluntersuchung kçnnen schwere Stçrungen der Nierendurchblutung erkannt und in Einzelfällen ein Transplantatverlust vermieden werden [7,8]. An unserer Einrichtung wird eine initiale postoperative FKDS, zumindest nach elektiver Lebendnierentransplantation, in der ersten postoperativen Stunde auf der chirurgischen Intensivstation durchgeführt, um eine akute arterielle oder vençse Durchblutungsstçrung auszuschliessen.…”

“…This includes a general assessment of transplant perfusion and measurement of base values. Severe impairment of renal perfusion may be diagnosed, thus avoiding loss of transplant in some cases [7,8]. In our institution, the initial post-operative CDS examination is carried out on the surgical intensive care unit, at least in cases of elective live-donor renal transplants, within the first post-operative hour, in order to exclude acute impairment of arterial or venous perfusion.…”