Assessment of Recipient Renal Transplant Arterial Graft Supply in the Immediate Postoperative Period (≤1 week): A...

Early detection of renal allograft complications can prompt immediate treatment to preserve graft function. Radiological evaluation of allograft vascular supply can be achieved with the use of a multimodal approach with Doppler ultrasonography, computed tomography, or magnetic resonance imaging. Although postoperative imaging is common, no consensus exists on the relationship between type of immediate postoperative imaging and short- and long-term graft outcomes.

We conducted a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. We searched the EMBASE, Medline, and Cochrane databases for studies published from January 1, 1995, to June 19, 2025. Inclusion criteria included any study that reported results of radiological imaging of the renal allograft obtained within 1 week of the renal transplant procedure.

Search results showed 36 studies that met the inclusion criteria. An average of 2.76 ±2.39 days was the time between the transplant procedure and the first imaging of the transplanted graft. All included studies described the use of Doppler ultrasonography in the evaluation of the graft function, with magnetic resonance angiography and renal scintigraphy also described. In reports showing radiological measurements within 1 week, 11 studies reported a significant relationship between radiological measurements and renal function, and 12 studies reported a significant relationship between radiological measurements and delayed graft function. At the 1 year posttransplant measurements, 8 studies reported that early abnormalities shown in radiological parameters suggested deterioration in long-term renal function measurements.

This systematic review demonstrated the utility of early imaging in the identification of early post-operative allograft complications.