Duplex ultrasound in the assessment of renal transplant complications

Duplex ultrasound was performed on 21 patients with renal transplants to assess the feasibility of detection of complications and, in particular, acute rejection and vascular abnormalities. A comparison of the results of Doppler waveform analysis in the transplant renal artery and morphological features on real time scanning in the detection and follow up of acute rejection was made. It was noted that there were characteristic alterations of Doppler shift spectral pattern in acute rejection, and these characteristics were more accurate, appeared earlier and showed a more consistent response to anti-rejection treatment than morphological changes demonstrated by real time ultrasound. Three patients had vascular abnormalities correctly predicted by duplex ultrasound and confirmed by angiography. These findings suggest that duplex ultrasound should be the investigation of choice in the initial assessment and follow up of renal transplant.