The diagnostic value of Doppler ultrasonography after pediatric kidney transplantation

Abstract

Ultrasonography (US) plays a major diagnostic role in the pre- and post-transplant evaluation of recipient and donor. In most cases, US remains the only necessary imaging modality. After pediatric kidney transplantation, US can ensure immediate bedside diagnosis of vessel patency and possible postoperative non-vascular complications. Criteria for US diagnosis of kidney vessel thrombosis and stenosis in the transplant will be presented. Non-vascular complications after kidney transplantation include hydronephrosis, hematoma, lymphocele, and abscess. US can detect suggestive, but nevertheless non-specific, acute signs (sudden increase in volume and elevated resistive index), and chronic rejection, which therefore remains a histological diagnosis. US is of little or no help in detection of tubular necrosis or drug toxicity, but it can exclude other differential diagnoses. This educational review provides a practical and systematic approach to a multimodal US investigation of the kidney transplant. It includes a short overview on possible indications for contrast-enhanced ultrasonography (CEUS) in children after kidney transplantation.

Renal Doppler Ultrasound in the Evaluation of Renal Function in Patients with Sepsis

“…Then, the blood flow in this zone is also further slowed, which results in a long transport time of inflammatory mediators in the blood vessels, so the exposure of capillary endothelial cells and renal tubular epithelial cells to inflammatory mediators is further prolonged. Ultimately, the inflammatory response is amplified, thus triggering a stress response [ 9 ]. Hence, it is necessary to examine and diagnose renal function in AKI patients.…”

Unveiling systemic responses in kidney transplantation: interplay between the allograft transcriptome and serum proteins

“…Coregulation analysis was applied to delineate RNA gene networks in the allograft transcriptome, resulting in 15 clusters (networks) with enrichment of specific functions ( Figure 1A ). The upper clusters (i.e., 1 , 3 , 13 , 14 ) showed a tubule signature with metabolic and transport functions. The lower clusters included lymphoid and myeloid immune functions and extracellular matrix (ECM)-related genes (clusters 2 , 7 ).…”

“…Gene networks (i.e., mean gene expression of all genes in the network) were correlated with the concentration of 159 serum proteins across 15 patients in an unsupervised manner using a Spearman-based similarity matrix. After hierarchical clustering, two main axes emerged: The metabolic gene clusters (i.e., 1 , 3 , 13 , 14 ) grouped together, and this axis was termed “metabolism” (MB) ( Figure 3A ). The second axis includes the immune-related gene clusters and is termed “inflammation” (INF).…”

“…The main reason is that graft damage is often detected late using routinely monitored parameters such as serum creatinine or albuminuria ( 1 , 2 ). While ultrasound examination is crucial in the clinical workup of graft dysfunction, its sensitivity is low compared to cellular or molecular assessments ( 3 ). Donor-specific antibody (DSA) monitoring is expensive, requires several days to obtain results, and does not reliably prove humoral rejection ( 4 , 5 ).…”

Non-contrast-enhanced magnetic resonance angiography as part of a kidney pretransplantation work-up in a 19-month-old boy – a case report

“…The Doppler ultrasound examination is the first line modality in the pre-KT evaluation of the recipient's deep abdominal vessels, particularly IVC and both iliac veins' patency [8]. However, its accuracy may be dependent on the patient's age and abdominal status, as well as the operator's experience [3,9].…”