Renal transplantation in adults

Breza,; Navratil,

doi:10.1046/j.1464-410x.1999.00203.x

Cited by 10 publications

(5 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…and hasten graft loss over time (4)(5)(6). Percutaneous renal transplant biopsy is currently the established method of differentiating between causes of acute graft dysfunction ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

Quantitative Evaluation of Acute Renal Transplant Dysfunction with Low-Dose Three-dimensional MR Renography

Yamamoto¹,

Zhang²,

Rusinek³

et al. 2011

Radiology

View full text Add to dashboard Cite

show abstract

“…and hasten graft loss over time (4)(5)(6). Percutaneous renal transplant biopsy is currently the established method of differentiating between causes of acute graft dysfunction ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

Quantitative Evaluation of Acute Renal Transplant Dysfunction with Low-Dose Three-dimensional MR Renography

Yamamoto¹,

Zhang²,

Rusinek³

et al. 2011

Radiology

View full text Add to dashboard Cite

show abstract

“…However, graft dysfunction is a major concern and early characterization of the underlying cause of graft dysfunction is important. Delayed treatment can lead to the irreversible loss of nephrons and hasten graft loss over time [94, 95]. Allograft rejection and acute tubular necrosis (ATN) are two important causes of early kidney allograft dysfunction, and it is difficult to discriminate between them by regular clinical tests.…”

Section: Renal Bold Mri Applicationsmentioning

confidence: 99%

Blood Oxygen Level-Dependent MR Imaging of the Kidneys

Halter

Prasad

2008

Magnetic Resonance Imaging Clinics of North America

View full text Add to dashboard Cite

SynopsisOxygenation status plays a major role in renal physiology and pathophysiology and hence has attracted considerable attention in recent years. While much of the early work and a significant amount of present work is based on invasive methods or ex vivo analysis and hence restricted to animal models, BOLD (blood oxygen level dependent) MRI has been shown to extend these findings to humans. BOLD MRI is most useful in monitoring effects of physiological or pharmacological maneuvers. Several teams around the world have demonstrated reproducible data and have illustrated several useful applications. Studies supporting the use of renal BOLD MRI in characterizing disease with prognostic value have also been reported. Here, an overview of the current state-of-the art of renal BOLD MRI is provided. KeywordsBOLD; kidney; MRI; oxygenation; blood flow; renal failure IntroductionRenal oxygenation status is receiving greater attention from both the scieintific and clinical communities [1][2][3]. In most organs, regional oxygen tension (pO 2 ) closely follows the level of regional blood flow, since oxygen consumption is relatively constant. But this is not true in the kidney, where active tubular reabsorption demands more oxygen consumption whenever filtration and blood flow rise together [4]. Over a wide range of normal blood flows the renal arterio-venous oxygen gradient is remarkably constant. For the purposes of function and oxygen supply, the mammalian kidney can be considered to be made of two separate organs, cortex and medulla [4]. The flow of blood to the renal cortex normally supplies oxygen far in excess of its metabolic needs. By contrast, blood flow to the renal medulla is parsimonious. In addition, oxygen diffuses from the arterial to venous vasa recta, and the process of generating an osmotic gradient by active reabsorption of sodium requires large amount of oxygen. All these combined, result in a poorly oxygenated medulla. A non-invasive method to evaluate this heterogeneous distribution of oxygen availability within the kidney is highly desirable. Blood oxygenation level dependent (BOLD) MRI has been shown to be useful in evaluating intra-renal oxygenation status both in animal models and in humans. In this article, we provide Corresponding author for proof and reprints: Pottumarthi V. Prasad, Radiology Department / Center for Advanced Imaging, Walgreen Building, Suite G507, Evanston Hospital, 2650 Ridge Avenue, Evanston, IL 60201, Tel: (847) 570-1349, E-mail: pprasad@enh.org. Coauthor(s) address(es): Luping Li and Sarah Halter, Radiology Department / Center for Advanced Imaging, Walgreen Building, Suite G507, Evanston Hospital, 2650 Ridge Avenue, Evanston, IL 60201, Tel: (847) 570-1948, E-mail: lli2@enh.org Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is ...

show abstract

“…Although advances in surgical techniques and immunosuppressive therapy have resulted in 1-year graft survival rates exceeding 90 percent, graft dysfunction in the early post-transplant period remains a serious clinical problem and an important factor in determining the ultimate fate of the allograft [1-3]. Graft dysfunction in the early post-transplant period results from a variety of causes, including cyclosporine toxicity, infection, vascular compromise, ureteral obstruction, acute tubular necrosis (ATN), and acute rejection [4, 5]. The compounding effects of acute rejection plus delayed graft function (DGF – defined as the need for dialysis during the first week post-transplantation) in the transplant course are devastating.…”

Section: Introductionmentioning

confidence: 99%

Quantitative MR Measures of Intrarenal Perfusion in the Assessment of Transplanted Kidneys

et al. 2009

View full text Add to dashboard Cite

Rationale and Objectives The purpose of this study was to evaluate prospectively a gadolinium-based perfusion technique for intrarenal blood flow in transplanted kidneys and to determine if magnetic resonance (MR) measurements of intrarenal perfusion could be used to differentiate between normal-functioning kidney allografts and allografts with acute tubular necrosis (ATN) or acute rejection. Materials and Methods Twenty-one subjects were enrolled within four months of receiving a kidney transplant. A biopsy was performed on subjects to diagnose each allograft as having either ATN or acute rejection. A group of subjects with normal functioning transplants were also enrolled in our study. MR perfusion images were acquired on a 1.5T MRI system within 48 hours after biopsy using an echo planar, T2*-weighted sequence and an injection of gadodiamide contrast agent administered at a dose of 0.1mmol/kg. Scan parameters were: TR/TE/flip=1000msec/30msec/60°, FOV=340×340mm, matrix=128×64, slice thickness=10mm, and temporal resolution=1.0sec. Cortical and medullary blood flow values were calculated. Results Medullary blood flow values were significantly (p=0.02) lower in allografts undergoing acute rejection (121±41 mL/100g/min) compared to normal-functioning allografts (221±96 mL/100g/min) and those with ATN (247±124 mL/100g/min). Cortical blood flow values were also significantly (p=0.03) reduced in allografts with acute rejection (243±116 mL/100g/min) compared to those with normal function (413±116 mL/100g/min). Conclusion Preliminary results indicate that MR perfusion techniques may provide a means of determining noninvasively the viability of renal allografts, potentially alleviating the need for biopsy in some patients.

show abstract

Renal transplantation in adults

Cited by 10 publications

References 28 publications

Quantitative Evaluation of Acute Renal Transplant Dysfunction with Low-Dose Three-dimensional MR Renography

Quantitative Evaluation of Acute Renal Transplant Dysfunction with Low-Dose Three-dimensional MR Renography

Blood Oxygen Level-Dependent MR Imaging of the Kidneys

Quantitative MR Measures of Intrarenal Perfusion in the Assessment of Transplanted Kidneys

Contact Info

Product

Resources

About