Ultrasonographic Evaluation of the Renal Transplant

Rodgers, Shuchi K.; Sereni, Christopher; Horrow, Mindy M.

doi:10.1016/j.rcl.2014.07.009

Cited by 38 publications

(25 citation statements)

References 33 publications

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“…The US appearance of a normal transplanted kidney is similar to that of a healthy native kidney, and the reniform outline and the central echo‐complex are well depicted with a usually clear distinction between renal cortex and medulla. Transplanted kidney size is similar to that of native ones with a gradual increase their dimensions; after 2 months the normal transplant kidney usually hypertrophies and can elongate by 2‐3 cm …”

Section: Imaging Techniques In Renal Transplant Follow‐upmentioning

confidence: 77%

Imaging in pediatric renal transplantation

Damasio

Müller

Piaggio

et al. 2017

Pediatric Transplantation

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Renal transplantation is the therapy of choice in children with ESKD. Radiological investigations are required in both pre- and post-transplant assessment, although there is paucity of both consensus-based statements and evidence-based imaging guidelines in pediatric renal transplantation. The phases of pediatric ESKD management that require imaging are pretransplantation recipient assessment and post-transplantation surveillance for detection of potential complications. We present suggestions for imaging algorithms for both pre- and post-transplant assessment in pediatric renal transplant recipients.

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Section: Imaging Techniques In Renal Transplant Follow‐upmentioning

confidence: 77%

Imaging in pediatric renal transplantation

Damasio

Müller

Piaggio

et al. 2017

Pediatric Transplantation

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“…If possible, communication directly with the transplant surgeon or correlation with the operative report is preferred before imaging evaluation (19, 20). In our institution, we often see patients post renal transplant referred from elsewhere without ready access to this information.…”

Section: Discussionmentioning

confidence: 99%

New Dimensions in Renal Transplant Sonography

et al. 2017

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Background The aim of this study is to demonstrate the usefulness of adding 3-dimensional (3D) ultrasound in evaluation of renal transplant vasculature compared to 2-dimensional (2D) Duplex ultrasound. Methods 113 consecutive renal transplant 2D and 3D ultrasound exams were performed and retrospectively reviewed by 2 Board-certified radiologists and a radiology resident individually; each reviewed 2D and then 3D images, including color and spectral Doppler. They recorded ability to visualize the surgical anastomosis and rated visualization on a subjective scale. Interobserver agreement was evaluated. Variant anastomosis anatomy was recorded. Tortuosity or stenosis was evaluated if localized Doppler velocity elevation was present. Results The reviewers directly visualized the anastomosis more often with 3D ultrasound (x̄ =97.5%) compared with 2D (x̄ =54.5%) [difference in means (DM) = 43% (95% confidence interval (CI) = 36%–50%), (p<0.001)]. The reviewers visualized the anastomosis more clearly with 3D ultrasound (p<0.001) [difference in medians = 0.5, 1.0, and 1.0, (95% CI = 0.5–1.0, 0.5–1.0 and 1.0–1.5)]. Detection of variant anatomy improved with 3D ultrasound by 2 reviewers [DM = 7.1% and 8.9% (95% CI = 1%–13% and 4%–14%, respectively), (p<0.05)]. There was high interobserver agreement [x̄ =95.3%, (95% CI = 91.9%–98.7%) regarding anastomosis visualization among reviewers with wide-ranging experience. Conclusions Direct visualization of the entire anastomosis was improved with 3D ultrasound. 3D evaluation improved detection of anatomic variants and identified tortuosity as the likely cause of borderline localized elevation in Doppler velocity. The data added by 3D ultrasound may obviate confirmatory testing with MRA or CTA following equivocal 2D ultrasound results.

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“…In general, complications after renal transplant are classified according to their origin: vascular, urological and surgical bed complications. Within the surgical bed complications, perigraft fluid collections (PFC) are one of the most frequent, with an incidence up to 50% depending on the series [ 10 ]. There is some controversy regarding these figures due to, among other reasons, the heterogeneity in the definition used.…”

Section: Introductionmentioning

confidence: 99%

Perigraft fluid collections after kidney transplantation: Does the type of donor (uncontrolled donation after circulatory death vs. donation after brain death) have a role?

Guerrero-Ramos

Cavero-Escribano

Rodrı́guez-Antolı́n

et al. 2017

CEJU

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IntroductionPerigraft fluid collection (PFC) is a common complication after kidney transplant. Its etiology is not clear and not all the causes have been identified. The influence of the type of donor has never been evaluated. Our aim was to compare the incidence, severity and management of PFC in recipients of grafts from uncontrolled donors after circulatory death (DCD) with normothermic extracorporeal membrane oxygenation (NECMO) versus recipients of grafts from donors after brain death (DBD).Material and methodsWe conducted a retrospective cohort study of 300 kidney transplants performed in our center between 2007 and 2012. Patients were divided in two groups: 150 recipients of Maastricht II DCD graft and 150 recipients of the DBD graft. Incidence, severity according to Clavien scale and management were analyzed in both groups, and comparison was carried out using Chi-square.ResultsOf the 300 kidney recipients analyzed, 93 (31.4%) suffered PFC, showing no difference between DBD (32.0%) and DCD (30.8%) groups (p = 0.9). Complicated PFC rate (defined as a PFC generating vascular compression, fever or urinary tract obstruction) was 22.9% in the DBD group versus 22.2% in the DCD group (p = 1); most complicated PFC were due to urinary tract obstruction (81%), with no difference between the groups (p = 1). Concerning Clavien scale, 78.5% of the PFC in our series were Clavien I, 19.4% Clavien IIIa and 2.2% Clavien IIIb, with no difference between both groups (p = 1).ConclusionsPFC is a frequent complication that appears in a third of our patients, showing no difference in the incidence or severity between DBD and uncontrolled DCD graft recipients.

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Ultrasonographic Evaluation of the Renal Transplant

Cited by 38 publications

References 33 publications

Imaging in pediatric renal transplantation

Imaging in pediatric renal transplantation

New Dimensions in Renal Transplant Sonography

Perigraft fluid collections after kidney transplantation: Does the type of donor (uncontrolled donation after circulatory death vs. donation after brain death) have a role?

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