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Evaluation of renal transplant dysfunction using color Doppler sonography
C P Johnson1, W D Foley, S Gallagher-Lepak
1Department of Transplant Surgery, Medical College of Wisconsin, Milwaukee.
Surgery, Gynecology & Obstetrics
|October 1, 1991
Summary
Color Doppler sonography (CDS) effectively detects renal transplant dysfunction. While less effective early post-transplant, CDS shows high specificity for rejection later, offering advantages over traditional methods.
Area of Science:
- Nephrology
- Radiology
- Transplant Surgery
Background:
- Renal transplant dysfunction (RTD) requires accurate diagnostic tools.
- Color Doppler sonography (CDS) assesses renal blood flow changes.
- Pulsatility index (PI) is a key parameter in CDS analysis.
Purpose of the Study:
- To evaluate the clinical performance of CDS in diagnosing RTD.
- To determine the sensitivity and specificity of CDS for specific complications.
- To compare CDS with conventional radionuclide imaging.
Main Methods:
- Reviewed 223 CDS measurements in 130 renal transplant recipients.
- Calculated pulsatility index (PI) and defined abnormal PI thresholds.
- Analyzed CDS performance in early and late post-transplant periods.
- Compared CDS with 99mTc DTPA renograms.
Main Results:
- CDS could not differentiate early post-transplant complications (ATN, obstruction, rejection).
- CDS showed 63% sensitivity and 92% specificity for rejection in the late period.
- Cyclosporine toxicity was not linked to abnormal PI.
- CDS was more sensitive than renography for rejection, though not statistically significant.
Conclusions:
- CDS is a valuable tool for evaluating RTD, particularly for detecting rejection postoperatively.
- CDS offers advantages in speed, cost, and portability over radionuclide imaging.
- CDS is likely to become a preferred imaging modality in renal transplantation.