Learning objectives
This review aims to-
Discuss relevant pre-operative imaging in recipients and donors.
Objectively evaluate transplanted kidney for potential complications/ forewarn rejection.
Background
Renal transplant is the most definitive and effective treatment for end-stage renal disease. It requires pre-operative workup of both the donor and recipient and subsequent post-operative evaluation of the recipient for potential complications using the various imaging modalities at hand, including but not limited to USG, CT, MRI with/without contrast.
Findings and procedure details
DONOR EVALUATION
To establish adequacy of donor kidney along with factors that change the operative approach or determine further course of treatment.
USGdetermines kidney size, presence of lesion that may change course of treatment.
Doppler/MR-Angiographyevaluate renal arterial and venous anatomy (accessory arteries/early bifurcations/stenoses/ circum-aortic or retro-aortic renal veins/ number of renal arteries with pre-hilar branching etc and vessel wall condition.
CT angiographyis more precise in determining length of the main renal artery before the first parenchymal branch and excluding renal artery or aortic abnormalities.
MR...
Conclusion
Aim of the radiologist in renal transplantation is to minimize donor complications by pre-operative evaluation while augmenting recipient benefits by both preoperative and postoperative evaluation with as little intervention as possible. Regular post-transplant checkup for early detection of complications is a must to ensure prolonged graft function.
Personal information and conflict of interest
Dr. I. Gurubharath MD Ph.D
Professsor & HOD Department of Radiodiagnosis
Velammal Medical College Hospital & Research Institute
Velammal,Madurai
Tamil Nadu- 625009, India.
Email:
[email protected]
Dr. Sukrati Ranjan
Postgraduate Resident
Department Of Radiodiagnosis
Shri Sathya Sai Medical College And Research Institute
Chennai, Tamil Nadu - 603108, India
Email :
[email protected]
Dr. Harshavardhan Balaganesan
Senior Resident
Department Of Radiodiagnosis
Shri Sathya Sai Medical College And Research Institute
Chennai, Tamil Nadu - 603108, India
Email :
[email protected]
The authors report no conflict of interest.
References
1.Catalá,Violeta, et al."Use of multidetector CT in presurgical evaluation of potential kidney transplant recipients."Radiographics30.2(2010):517-531
2.Rifkin,Matthew D.,et al. "Evaluation of renal transplant rejection by duplex Doppler examination:value of the resistive index."American Journal of Roentgenology148.4(1987):759-762.
3. Sjekavica,Ivica,et al."Radiological Imaging in Renal Transplantation."Acta Clinica Croatica57.4(2018):694
4.Akbar,SyedA.,et al."Complications of renal transplantation."Radiographics25.5(2005):1335-1356