Purpose
Surgical complications in the immediate post-transplant period occur in 5-10% of patients after the kidney transplant,
most of them may affect parenchymal perfusion.
One of the most serious postoperative complications are the renal artery (transplant renal artery stenosis – TRAS).
Critical TRAS defined as the stenosis greater than 70% has usually non-specific clinical manifestation.
A lower degree of stenosis (50-69%) are usually asymptomatic and therefore cause serious diagnostic difficulties.
Fig.1Clinical manifestations of TRAS include difficulties to achieve adequate blood pressure control,
impairment of the excretory,...
Methods and Materials
This study is based on the analysis of CE-US examinations performed in 10 patients after kidney transplantation,
all patients were diagnosed with TRAS in the postoperative period (mean age: 40 SD 11.1,
range: 19-65).
The cases of TRAS are derived from the observation of 120 consecutive patients who underwent the CE-US after renal transplantation (mean age: 46 SD 12.5,
range: 19-65).
The diagnosis of TRAS was made 1-14 days after transplantation on the basis of standardized test B + US-CD/PD/PW.Immediately after the B + US-CD/PD/PW...
Results
Based on the B + US-CD/PD/PW examination TRAS of different degree was diagnosed in 10 (8.3%) consecutive patients after kidney transplantation.
The diagnosis of TRAS was confirmed in all cases by reference methods (MRA and CTA).
Fig.2,3
In all patients who were diagnosed with postoperative TRAS delayed secretory function (DGF) occurred and those individuals required dialysis for an average of 11 ± 6.7 days after transplantation.
In the patients without stenosis CE inflow time to cortex (time t1) ranged from 0.8 to 2.6 seconds (mean...
Conclusion
CE-US allows for quick and non-invasive assessment of perenchymal kidney graft perfusion.
It enables to confirm diagnosis of TRAS in the early postoperative period.
References
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Fischer...