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A Rat Orthotopic Renal Transplantation Model for Renal Allograft Rejection
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Renal Allograft Dysfunction: Evaluation with Shear-wave Sonoelastography.

Nitin P Ghonge1, Mohita Mohan1, Vikas Kashyap1

  • 1From the Departments of Radiology (N.P.G., M.M.), Pathology (V.K.), and Nephrology (S.J.), Indraprastha Apollo Hospital, Delhi Mathura Rd, Sarita Vihar, New Delhi 110076, India.

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Summary

Shear-wave sonoelastography effectively differentiates stable kidney transplants from acute and chronic dysfunction. This non-invasive technique correlates parenchymal stiffness with graft function, aiding clinical assessment.

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Area of Science:

  • Nephrology
  • Radiology
  • Transplant Surgery

Background:

  • Renal allograft dysfunction is a major complication after transplantation.
  • Accurate differentiation between stable and dysfunctional allografts is crucial for timely intervention.
  • Current diagnostic methods may be invasive or lack specificity.

Purpose of the Study:

  • To assess shear-wave sonoelastography's ability to distinguish stable renal allografts from acute and chronic allograft dysfunction.
  • To correlate shear-wave sonoelastography measurements with established clinical and histological markers.

Main Methods:

  • Prospective study of 60 renal transplant recipients.
  • Classification of patients into stable allograft, acute dysfunction, or chronic dysfunction groups.
  • Measurement of mean parenchymal stiffness using shear-wave sonoelastography.
  • Correlation with resistive index (RI), serum creatinine, estimated glomerular filtration rate (eGFR), and Banff scores.

Main Results:

  • Mean parenchymal stiffness was significantly higher in chronic allograft dysfunction (24.50 kPa) and acute allograft dysfunction (11.06 kPa) compared to stable allografts (8.51 kPa).
  • Parenchymal stiffness correlated negatively with eGFR and positively with RI and serum creatinine.
  • Sensitivity and specificity for differentiating stable from acute dysfunction were 73.68% and 80%, respectively.

Conclusions:

  • Shear-wave sonoelastography can differentiate stable renal allografts from those with acute or chronic dysfunction.
  • Parenchymal stiffness measurements reflect the functional status of the renal allograft.
  • This technique offers a non-invasive tool for assessing renal allograft health.