Quantified Power Doppler As a Predictor of Delayed Graft Function After Renal Transplantation

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 2014 Dec 16

PMID 25503640

Citations 5

Authors

Mariana Moraes Contti

Paula Dalsoglio Garcia

Cristiane Akemi Kojima

Hong Si Nga

Maria Fernanda Cordeiro de Carvalho

Luis Gustavo Modelli de Andrade

Affiliations

Soon will be listed here.

Abstract

Purpose: No safe ultrasound (US) parameters have been established to differentiate the causes of graft dysfunction.

Objectives: To define US parameters and identify the predictors of normal graft evolution, delayed graft function (DGF), and rejection at the early period after kidney transplantation.

Methods: Between June 2012 and August 2013, 79 renal transplant recipients underwent US examination 1-3 days posttransplantation. Resistive index (RI), power Doppler (PD), and RI + PD (quantified PD) were assessed. Patients were allocated into three groups: normal graft evolution, DGF, and rejection.

Results: Resistive index of upper and middle segments and PD were higher in the DGF group than in the normal group. ROC curve analysis revealed that RI + PD was the index that best correlated with DGF (cutoff = 0.84). In the high RI + PD group, time to renal function recovery (6.33 ± 6.5 days) and number of dialysis sessions (2.81 ± 2.8) were greater than in the low RI + PD group (2.11 ± 5.3 days and 0.69 ± 1.5 sessions, respectively), p = 0.0001. Multivariate analysis showed that high donor final creatinine with a relative risk (RR) of 19.7 (2.01-184.7, p = 0.009) and older donor age (RR = 1.17 (1.04-1.32), p = 0.007) correlated with risk DGF.

Conclusions: Quantified PD (RI + PD) was the best DGF predictor. PD quantification has not been previously reported.

Citing Articles

Performance of resistive index and semi-quantitative power doppler ultrasound score in predicting acute kidney injury: A meta-analysis of prospective studies.

Wei Q, Zhu Y, Zhen W, Zhang X, Shi Z, Zhang L PLoS One. 2022; 17(6):e0270623.

PMID: 35763514 PMC: 9239473. DOI: 10.1371/journal.pone.0270623.

Renal echography for predicting acute kidney injury in critically ill patients: a prospective observational study.

Zhi H, Li Y, Wang B, Cui X, Zhang M, Hu Z Ren Fail. 2020; 42(1):263-269.

PMID: 32160803 PMC: 7144271. DOI: 10.1080/0886022X.2020.1737544.

Sonographic Indices in Patients with Severe Acute Tubular Necrosis during Early Post-Kidney Transplantation Period.

Bagheri S, Tajalli F, Shahrokh H, Nasiri Partovi M, Azadian N Int J Organ Transplant Med. 2019; 10(2):74-83.

PMID: 31285804 PMC: 6604759.

Increase in Serum Amylase and Resistive Index After Kidney Transplant Are Biomarkers of Delayed Graft Function.

Comai G, Baraldi O, Cuna V, Corradetti V, Angeletti A, Brunilda S In Vivo. 2018; 32(2):397-402.

PMID: 29475927 PMC: 5905212. DOI: 10.21873/invivo.11252.

Emphysematous pyelonephritis in a transplanted kidney.

Oliveira C, Garcia P, Viero R Autops Case Rep. 2017; 6(4):41-47.

PMID: 28210573 PMC: 5304561. DOI: 10.4322/acr.2016.051.

References

Kamali K, Abbasi M, Ani A, Zargar M, Shahrokh H . Renal transplantation in allografts with multiple versus single renal arteries. Saudi J Kidney Dis Transpl. 2012; 23(2):246-50. View

Pascual M, Vallhonrat H, Cosimi A, Tolkoff-Rubin N, Colvin R, Delmonico F . The clinical usefulness of the renal allograft biopsy in the cyclosporine era: a prospective study. Transplantation. 1999; 67(5):737-41. DOI: 10.1097/00007890-199903150-00016. View

Koning O, Ploeg R, van Bockel J, Groenewegen M, van der Woude F, Persijn G . Risk factors for delayed graft function in cadaveric kidney transplantation: a prospective study of renal function and graft survival after preservation with University of Wisconsin solution in multi-organ donors. European Multicenter Study Group. Transplantation. 1997; 63(11):1620-8. DOI: 10.1097/00007890-199706150-00015. View

Lechevallier E, Dussol B, Luccioni A, Thirion X, Jaber K, Brunet P . Posttransplantation acute tubular necrosis: risk factors and implications for graft survival. Am J Kidney Dis. 1998; 32(6):984-91. DOI: 10.1016/s0272-6386(98)70073-3. View

Dunn E . Radioisotopic evaluation of renal transplants. Urol Radiol. 1992; 14(2):115-26. DOI: 10.1007/BF02926912. View

Hetzel G, Klein B, Brause M, Westhoff A, Willers R, Sandmann W . Risk factors for delayed graft function after renal transplantation and their significance for long-term clinical outcome. Transpl Int. 2002; 15(1):10-6. DOI: 10.1007/s00147-001-0368-7. View

Chow L, Sommer F, Huang J, Li K . Power Doppler imaging and resistance index measurement in the evaluation of acute renal transplant rejection. J Clin Ultrasound. 2001; 29(9):483-90. DOI: 10.1002/jcu.10010. View

Shebel H, Akl A, Dawood A, El-Diasty T, Shokeir A, Ghoneim M . Power doppler sonography in early renal transplantation: does it differentiate acute graft rejection from acute tubular necrosis?. Saudi J Kidney Dis Transpl. 2014; 25(4):733-40. DOI: 10.4103/1319-2442.134948. View

Aktas A . Transplanted kidney function evaluation. Semin Nucl Med. 2014; 44(2):129-45. DOI: 10.1053/j.semnuclmed.2013.10.005. View

10.

Jimenez C, Lopez M, Gonzalez E, Selgas R . Ultrasonography in kidney transplantation: values and new developments. Transplant Rev (Orlando). 2009; 23(4):209-13. DOI: 10.1016/j.trre.2009.06.003. View

11.

Irshad A, Ackerman S, Sosnouski D, Anis M, Chavin K, Baliga P . A review of sonographic evaluation of renal transplant complications. Curr Probl Diagn Radiol. 2008; 37(2):67-79. DOI: 10.1067/j.cpradiol.2007.06.001. View

12.

Friedewald S, Molmenti E, Friedewald J, Dejong M, Hamper U . Vascular and nonvascular complications of renal transplants: sonographic evaluation and correlation with other imaging modalities, surgery, and pathology. J Clin Ultrasound. 2005; 33(3):127-39. DOI: 10.1002/jcu.20105. View

13.

Rubin J, Bude R, Carson P, Bree R, Adler R . Power Doppler US: a potentially useful alternative to mean frequency-based color Doppler US. Radiology. 1994; 190(3):853-6. DOI: 10.1148/radiology.190.3.8115639. View

14.

Baxter G, Rodger R . Doppler ultrasound in renal transplantation. Nephrol Dial Transplant. 1997; 12(11):2449-51. DOI: 10.1093/ndt/12.11.2449. View

15.

Wang H, Chou Y, Yang A, Chiou S, Chiou H, Wu T . Evaluation of cortical perfusion in renal transplants: application of quantified power Doppler ultrasonography. Transplant Proc. 2008; 40(7):2330-2. DOI: 10.1016/j.transproceed.2008.06.046. View

16.

Silva D, Garcia J, Ribeiro A, Veronese F, Edelweiss M, Goncalves L . Utility of biopsy in kidney transplants with delayed graft function and acute dysfunction. Transplant Proc. 2007; 39(2):376-7. DOI: 10.1016/j.transproceed.2007.01.008. View

17.

Naesens M, Heylen L, Lerut E, Claes K, De Wever L, Claus F . Intrarenal resistive index after renal transplantation. N Engl J Med. 2013; 369(19):1797-806. DOI: 10.1056/NEJMoa1301064. View

18.

Chudek J, Kolonko A, Krol R, Ziaja J, Cierpka L, Wiecek A . The intrarenal vascular resistance parameters measured by duplex Doppler ultrasound shortly after kidney transplantation in patients with immediate, slow, and delayed graft function. Transplant Proc. 2006; 38(1):42-5. DOI: 10.1016/j.transproceed.2005.12.013. View

19.

Tranquart F, Lebranchu Y, Haillot O, Pourcelot D, Grezard O, Pourcelot L . The use of perioperative Doppler ultrasound as a screening test for acute tubular necrosis. Transpl Int. 1993; 6(1):14-7. DOI: 10.1007/BF00336632. View