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
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 1.48 sec.),
and pyramids (time t2) from 0.9 to 3.7 seconds (mean 2.15 sec.).
Fig.4 Time of CE inflow to the graft parenchyma was significantly longer.
For cortex it ranged from 2.5 to 4.35 seconds (mean 3.32 sec.) for the pyramids 4,0-8,2 seconds (mean 6.11 sec.) Fig.5.
By analysing the time of CE inflow into selected areas of the parenchyma significant difference were noted between patients with undisturbed CE saturation and patients with decreased inflow due to TRAS (mean time for cortex was 1.48 ± 3.7 vs 3.32 ± 3.8 s,
p <0.19 and for pyramids 2.15 ± 3.9 vs 6.11 ± 3.8 s,
p <0.2).
We also analyzed a correlation between TRAS severity assessed on the basis of CTA / MRA and the rate of CE inflow (t1 and t2) into selected areas of the parenchyma. The correlation was statistically significant and tight (R=0.97 for t1 and 0.9 for t2; p<0.001).
After 6 month from kidney transplant patients with a history of TRAS had significantly higher serum creatinine level than recipients with a normal renal artery blood flow (1.78 mg/dL vs 1.51 mg/dl,
p<0.02).
Estimated GFR was also decreased 35.7 ml/min vs 46.4 ml/min,
respectively (p<0.05).