Keywords:
Transplantation, Haemodynamics / Flow dynamics, Grafts, Contrast agent-other, Contrast agent-intravenous, Computer Applications-3D, Ultrasound-Spectral Doppler, Ultrasound-Colour Doppler, Ultrasound, Vascular, Kidney, Contrast agents
Authors:
P. Grzelak, I. Kurnatowska, L. Stefanczyk; Łodz/PL
DOI:
10.1594/ecr2013/C-2390
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 had been performed CE-US examination.
It was carried out after intravenous administration of SonoVue Diagnostics (Bracco Int.) in dose of 2.4 mL per examination (Milan,
Italy).
The diagnosis of TRAS was confirmed in all cases by MRA,
magnetic resonance angiography (Siemens Avanto,
Phase contrast angiography,
Gadovist) or CTA,
computed tomography angiography (GE Light-Speed,
minutes of contrast,
400 Iomeron).
All kidneys for transplantation were from deceived donors.
All patients received standard triple immunosuppressive therapy,
no antibody induction therapy was used.
Ultrasound studies were performed using GE Vivid 7,
with a convex probe (type 3.5C).
The CE-US examination protocol included recording of 30 second long dynamic cine loop in the long axis of the kidney visualising the inflow of CE to the KTX.
The data was analyzed quantitatively on a workstation (EchoPack,
software Q-analyze,
GE) with the time intensity curves (TIC).
The rate of the CE inflow was evaluated in the cortex (time t1) and renal pyramids (time t2).
For statistical analysis assumed rise time TIC curve to reach its maximum. The results of patients with TRAS was compared to the results of 110 transplant patients from our database of CE-US studies without TRAS or other critical complications in postoperative period.
All results are expressed as mean ± SD.
Statistical significance was defined at p<0.05.
The normality of data distribution was checked by Shapiro-Wilk test,
and non-normally distributed data were logarithmically transformed before analysis.
Between-group comparisons were performed using t-test for repeated measurements or the Wilcoxon sign rank test for normally and non-normally distributed data,
respectively.
The Pearson or Spearman correlation coefficient was used to assess relations between the variables.
All subjects gave their written informed consent for the participation in the study and the study protocol was approved by the Bioethics Committee of the Medical University of Lodz,
Poland.