Type:
Educational Exhibit
Keywords:
Kidney, Vascular, Urinary Tract / Bladder, Ultrasound-Colour Doppler, Ultrasound-Spectral Doppler, CT-Angiography, Diagnostic procedure, Transplantation
Authors:
R. Gaio1, G. Freire2, R. P. Lameira3, R. Martins4, L. M. B. Vítor1; 1Lisboa/PT, 2Loures/PT, 3Lisboa, Lisboa/PT, 4Lisbon/PT
DOI:
10.26044/ecr2019/C-3332
Background
Renal transplantation is the treatment of choice for patients with end-stage renal disease,
promoting longer overall survival compared with peritoneal dialysis and hemodialysis.
With the increasing new classes of immunosuppressive drugs,
the incidence of rejection as significantly been reduced and other types of complications have come to the forefront.
Complications after renal transplantation can be divided into three different categories: functional,
perirenal/excretory system,
vascular (table 1).
Knowledge of the time spent between the surgical procedure and the DUS evaluation is also important to predict the type of complications that can appear (table 2): immediate complications occur within the first week after surgery; early complications occur between the 1st and the 12th weeks; late complications occur after the 12th week.
Long-term complications include de novo glomerulonephritis and recurrent disease,
among others.
Vascular complications (renal artery and/or vein thrombosis,
renal artery/renal vein stenosis,
ateriovenous fistula and pseudoaneurysms) represent 5-10% of all complications after renal transplantation and the most common vascular complication is renal artery stenosis.
These complications have different timings of presentation and characteristic imaging findings on DUS (which is usually the first imaging modality to be used) and on CTA.