38th National Congress of the Italian Transplantation SocietyKidney transplantationLong-Term Prognostic Impact of Contrast-Enhanced Ultrasound and Power Doppler in Renal Transplantation
Section snippets
Materials and Methods
We evaluated 39 kidney allograft recipients, 27 male and 12 female, between 17 and 74 years old. Eight were double transplants for extended-criteria donors (left + right Karpinsky score 8.2 ± 0.75). In 1 case, an intraoperative explant was performed because of severe bleeding. In the first year of follow-up, we performed laboratory tests and US and CEUS studies on day 5 (T0), day 15 (T1), day 30 (T2), month 3 (T3), month 6 (T4), year 1 (T5), year 2 (T6), year 3 (T7), and year 4 (T8). After the
Results
A total of 34 patients completed a 4-year follow-up, 3 restarted dialysis within 2 months from transplantation (1 urinary fistula with urosepsis, 1 inferior allograft pole pseudoaneurism rupture, 1 type 1 Banff acute rejection), 1 after 29 months (double transplantation, chronic allograft nephropathy, and calcineurin inhibitors toxicity), and 1 died because of myocardial infarction just before the end of follow-up. Overall graft and recipient 4-year survival is 87.2% (SE 0.054). Fourteen
Discussion
Our data show that the first year after transplantation is the most critical for later evolution of RA function. In this period, we observed 9 of 14 rejections and 3 of 4 kidney failures requiring dialysis. The trend of GFR confirms these data, with a steep decrease in the first year but a substantial stability in the next 3 years. RI also tends to decrease along the follow-up (probably because of the loss of the worst cases due to death or allograft failure), keeping a negative correlation to
Conclusions
US and CEUS offer an interesting perspective for long-term prediction of kidney allograft function. RI was shown to be sensitive, relating to graft dysfunction, whereas CEUS parameters were specific, relating to parenchymal perfusion. The maintenance of stable GFR, low RI, and good cortical perfusion parameters according to the CEUS gamma variate model should predict a slow reduction of GFR over time. Further investigation is needed to obtain more significant data on hard endpoints (death and
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Role of Contrast-Enhanced Ultrasound in the Follow-up of Kidney Transplant Patients
2016, Transplantation ProceedingsContrast-Enhanced Ultrasonography Value for Early Prediction of Delayed Graft Function in Renal Transplantation Patients
2023, Journal of Ultrasound in MedicineDiagnostic value of contrast-enhanced ultrasound (CEUS) in kidney allografts-12 years of experience in a tertiary referral center
2022, Clinical Hemorheology and Microcirculation