Learning objectives
Doppler-ultrasonography (Doppler-US),
is an excellent screening method for potential complications of renal transplantation.
Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are often reserved for undetermined findings.
The purpose of this poster is to review the post-surgical anatomy and the Doppler-US and CT findings of the renal transplant complications encountered in our institution between 2010-2017.
Background
Renal transplantation is the treatment of choice for patients with end-stage renal disease and is associated with improved survival compared with maintenance dialysis.
Five-year unadjusted allograft survival rates for a primary deceased donor transplant have been reported to be 72.4% [1],
while for a first living donor kidney transplant and a second or subsequent transplant they were reported to be 84.6% and 81.4%,
respectively [1].
Surgical Technique
Whilst the transplanted kidney can be placed either in the right or left iliac fossa,
it is usually...
Findings and procedure details
Complications
Post-transplant complications can be divided into perinephric fluid collections,
parenchymal (acute tubular necrosis,
acute rejection and infection),
urologic/post-renal (intrinsic and extrinsic factors obstructing the collecting system) and vascular/pre-renal.
1.
Perinephric fluid collections
In our institution,
perinephric fluid collections were found to be the most common complication and have been reported in up to 50% [4] of renal transplantations.
They include hematomas,
lymphoceles,
urinomas and abcesses.
Small perinephric fluid collections,
most frequently representing hematomas or seromas,
are an expected finding.
In effect,
the clinical importance...
Conclusion
US and Doppler-US still play a critical role in graft evaluation,
in particular during the immediate postoperative period.
They arealso important in guiding percutaneous drainage and biopsy procedures.
An understanding of the renal transplant procedure and the normal and abnormal colour and spectral appearances of Doppler-US of a renal graft is crucial.
While post-transplant vascular complications were rarely found over the last 7 years,
surgical complications were frequently encountered,
with perinephric fluid collections,
specifically hematomas,
being the most common.
Contrast-enhanced CT and MRI are currently...
References
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