World Journal of Urology

, Volume 29, Issue 4, pp 547–553 | Cite as

Immediate renal Doppler ultrasonography findings (<24 h) and its association with graft survival

  • Javier Barba
  • Jorge Rioja
  • José Enrique Robles
  • Anibal Rincón
  • David Rosell
  • Juan Javier Zudaire
  • José María Berian
  • Ignacio Pascual
  • Alberto Benito
  • Pedro Errasti
Original Article

Abstract

Purpose

Renal Doppler ultrasonography (DUS) is the gold-standard image test for follow-up after renal transplantation, it is potentially useful to detect renal disease and it could be related with long-term survival. We evaluate whether renal graft survival can be predicted by immediate renal Doppler ultrasonography (IRDUS), defined as ultrasonography carried out in the first 24 h post-surgery.

Materials and methods

Immediate renal DUS findings (resistance index, hydronephrosis, fluid collection, bruises, and vascularization abnormalities) and their association with graft survival were analyzed in a retrospective observational study of 343 renal allografts. Renal transplantation was done using a standard technique, and DUS was performed 24 h post-transplantation. The association of variables with graft survival was evaluated by Cox univariate and multivariate proportional hazards analysis. Kaplan–Meier survival analysis and the log-rank test were used to examine graft survival.

Results

The follow-up median was 85 months. On IRDUS, 137 patients (39.9%) had abnormal findings. The best RI cutpoint for the prediction of graft survival was 0.7; therefore, we defined two different groups: RI ≤ 0.7 (n = 247) versus RI > 0.7 (n = 96). Univariate analysis revealed that graft survival was significantly lower in patients with RI > 0.7 (P ≤ 0.001), vascularization abnormalities (P ≤ 0.001) or bruises (P = 0.026). In multivariate analysis, the only factors independently associated with graft survival were RI (odds ratio 2.4; 95% CI 1.4–4.1) and vascularization abnormalities (odds ratio 2.7; 95% CI 1.1–6.5).

Conclusions

IRDUS can be useful, besides being highly useful in the diagnosis of graft primary dysfunction in the transplanted patient also yields information that can help to predict long-term graft survival.

Keywords

Kidney transplantation Graft survival Doppler ultrasonography Predictive value 

Abbreviations

CI

Confidence interval

DUS

Doppler ultrasonography

IRDUS

Immediate renal Doppler ultrasonography

OR

Odds ratio

RI

Resistance index

SD

Standard deviation

BMI

Body mass index

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Javier Barba
    • 1
  • Jorge Rioja
    • 2
  • José Enrique Robles
    • 1
  • Anibal Rincón
    • 1
  • David Rosell
    • 1
  • Juan Javier Zudaire
    • 1
  • José María Berian
    • 1
  • Ignacio Pascual
    • 1
  • Alberto Benito
    • 3
  • Pedro Errasti
    • 4
  1. 1.Department of UrologyUniversity of Navarra ClinicPamplonaSpain
  2. 2.Department of UrologyMiguel Servet HospitalZaragozaSpain
  3. 3.Radiology ServiceUniversity of Navarra ClinicPamplonaSpain
  4. 4.Department of NephrologyUniversity of Navarra ClinicPamplonaSpain

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