Correlation of echographic and histologic findings in suspected renal allograft rejection

Immunologic renal allograft rejection is the most common cause of diminished renal function in the transplant patient, yet it is difficult to distinguish from other etiologies, frequently requiring biopsy before therapy can be instituted. To determine the utility of ultrasound in the diagnosis of this type of rejection, the authors correlated histologic and echographic findings of 30 coded biopsies and sonograms in 25 patients. The results were encouraging, with a 71% rate of accuracy in indicating steroid therapy for acute rejection and an accuracy rate of 81% in contraindicating it. There was exact agreement of echographic and histologic evaluations as to extent of chronic rejection in 70% of cases.