1. Discuss the role of imaging in renal transplantation. 2. Review the normal appearance of a renal transplant on ultrasound. 3. Describe possible complications of renal transplantation and review a series of cases demonstrating how imaging can be used to characterise these.

Renal transplantation offers benefits in both quantity and quality of life for many patients with end stage renal failure and is the treatment of choice [1, 2]. Once a patient has received a transplant, close monitoring is vital to identify potential problems promptly in order to facilitate management and keep the kidney healthy. Imaging plays a vital role in the assessment of renal transplants in both the immediately post-operative period to identify early complications and in the months and years after to identify later complications.

Renal transplants are usually located in the extraperitoneal space in the right iliac fossa. Variations of this include left iliac fossa and intraperitoneal transplantation. The renal artery is usually anastomosed to the external iliac artery and the renal vein to the external iliac vein. Variations to this include anastomosis of the internal iliac artery to the renal graft and multiple arteries / veins. The ureter is commonly anastomosed directly to the bladder (ureterneocystotomy), however other techniques such as anastomosis to a native ureter can also...

A variety of complications can occur after renal transplantation and ultrasound is the initial modality of choice to assess the kidney, allowing detailed assessment of the vasculature, urinary tract and parenchyma. Other modalities are sometimes required to complement this andallow further characterisation.

1. Ming H & Taylor J. Renal Transplantation. BMJ 2014;348:bmj.g68 2. Leong KG, Coombs P, Kanellis J. Renal transplant ultrasound: the nephrologist’s perspective. AJUM 2015;18(4):134-142 3. Akbar SA, Jafri ZH, Amendola MA, Madrazo BL, Salem R & Bis KG. Complications of Renal Transplantation. RadioGraphics 2005;25:1335-1356 4. Fananapazir G, McGahan J, Corwin M, Stewart S, Cu C, Wright L, Troppmann C. Screening for Transplant Renal Artery Stenosis: Ultrasound-Based Stenosis Probability Stratification. AJR 2017;209:1064-1073 5. Brown ED, Chen MY, Wolfman NT, Ott DJ, Watson NE. Complications of...