Learning objectives
1.
To go over normal findings after recent transplantation.
2.
To review early complications classification and frequency.
3.
To illustrate their radiologic features with US and CT correlation.
Background
As the world population ages and end-stage renal disease raises the amount of patients treated by renal replacement therapies continues increasing.
Radiologist must be familiarized with this practice.
IMAGING TECHNIQUES
Most popular imaging techniques are ultrasounds (US) and helical computed tomography (CT).
US can be used in the post-operative period,
to detect vascular complications and for long-term follow-up.
Also to guide diagnostic and therapeutic interventions.
CT is helpful in cases in which US yield non-diagnostic findings.
CT depicts anatomy in great detail and CT angiography...
Findings and procedure details
NORMAL FINDINGS AT US AND CT AFTER RENAL TRASPLANTATION
Ultrasound (Image 1)
A complete US evaluation should include B-mode,
Doppler-color and Doppler-spectral imagines:
Renal parenchyma: normal transplanted kidney demonstrates no differences in comparisonwith a normal native kidney.
Length: Variations in size of the graft are indirect sings of pathology.
Cortico-medullary differentiation: Usually,
cortico-medullary differentiation in a transplanted kidney is more pronounced,
due to its more superficial location.
Cortical assessment: higher-frequency transducers allow better appreciation of the individual cortical segments.
Collector system: Assessment of whether or...
Conclusion
Kidney postransplantation complications are common.
Imaging techniques are essential for their adequate management.
Radiologists need to be acquainted with the normal and pathologic findings that can be found in this scenario.
References
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Ultrasonographic evaluation of the renal transplant.
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A Review of Sonographic Evaluation of Renal Transplant Complications.
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37(2),
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Rajiah,
P.
et all (2006).
Renal transplant imaging and complications.
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31(6),
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Fallon,
B.
et all (2004).
Renal Transplantation: Surgical Procedure and Complications.
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Harmath,
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Renal Pretransplantation Work-up,
Donor,
Recipient,
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Radiologic Clinics of North...