Skip to main content

Quantified power Doppler as a predictor of delayed graft function after renal transplantation

Abstract

Purpose

No safe ultrasound (US) parameters have been established to differentiate the causes of graft dysfunction.

Objectives

To define US parameters and identify the predictors of normal graft evolution, delayed graft function (DGF), and rejection at the early period after kidney transplantation.

Methods

Between June 2012 and August 2013, 79 renal transplant recipients underwent US examination 1–3 days posttransplantation. Resistive index (RI), power Doppler (PD), and RI + PD (quantified PD) were assessed. Patients were allocated into three groups: normal graft evolution, DGF, and rejection.

Results

Resistive index of upper and middle segments and PD were higher in the DGF group than in the normal group. ROC curve analysis revealed that RI + PD was the index that best correlated with DGF (cutoff = 0.84). In the high RI + PD group, time to renal function recovery (6.33 ± 6.5 days) and number of dialysis sessions (2.81 ± 2.8) were greater than in the low RI + PD group (2.11 ± 5.3 days and 0.69 ± 1.5 sessions, respectively), p = 0.0001. Multivariate analysis showed that high donor final creatinine with a relative risk (RR) of 19.7 (2.01–184.7, p = 0.009) and older donor age (RR = 1.17 (1.04–1.32), p = 0.007) correlated with risk DGF.

Conclusions

Quantified PD (RI + PD) was the best DGF predictor. PD quantification has not been previously reported .

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3

References

  1. Jimenez C, Lopez MO, Gonzalez E, Selgas R (2009) Ultrasonography in kidney transplantation: values and new developments. Transplant Rev (Orlando) 23(4):209–213

    Article  Google Scholar 

  2. Friedewald SM, Molmenti EP, Friedewald JJ, Dejong MR, Hamper UM (2005) Vascular and nonvascular complications of renal transplants: sonographic evaluation and correlation with other imaging modalities, surgery, and pathology. J Clin Ultrasound 33(3):127–139

    PubMed  Article  Google Scholar 

  3. Irshad A, Ackerman S, Sosnouski D, Anis M, Chavin K, Baliga P (2008) A review of sonographic evaluation of renal transplant complications. Curr Probl Diagn Radiol 37(2):67–79

    PubMed  Article  Google Scholar 

  4. Rubin JM, Bude RO, Carson PL, Bree RL (1994) Power Doppler US: a potentially useful alternative to mean frequency-based color Doppler US. Radiology 190(3):853–856

    CAS  PubMed  Article  Google Scholar 

  5. Lechevallier E, Dussol B, Luccioni A, Thirion X, Vacher-Copomat H, Jaber K et al (1998) Posttransplantation acute tubular necrosis: risk factors and implications for graft survival. Am J Kidney Dis 32(6):984–991

    CAS  PubMed  Article  Google Scholar 

  6. Kamali K, Abbasi MA, Ani A, Zargar MA, Shahrokh H (2012) Renal transplantation in allografts with multiple versus single renal arteries. Saudi J Kidney Dis Transplant 23(2):246–250

    Google Scholar 

  7. Baxter GM, Rodger RS (1997) Doppler ultrasound in renal transplantation. Nephrol Dial Transplant 12(11):2449–2451

    CAS  PubMed  Article  Google Scholar 

  8. Dunn EK (1992) Radioisotopic evaluation of renal transplants. Urol Radiol 14(2):115–126

    CAS  PubMed  Article  Google Scholar 

  9. Aktaş A (2014) Transplanted kidney function evaluation. Semin Nucl Med 44(2):129–145

    PubMed  Article  Google Scholar 

  10. Silva DM, Garcia JP, Ribeiro AR, Veronese FJ, Edelweiss MI, Gonçalves LF et al (2007) Utility of biopsy in kidney transplants with delayed graft function and acute dysfunction. Transplant Proc 39(2):376–377

    CAS  PubMed  Article  Google Scholar 

  11. Pascual M, Vallhonrat H, Cosimi AB, Tolkoff-Rubin N, Colvin RB, Delmonico FL et al (1999) The clinical usefulness of the renal allograft biopsy in the cyclosporine era: a prospective study. Transplantation 67(5):737–741

    CAS  PubMed  Article  Google Scholar 

  12. Pallardó Mateu LM, Sancho Calabuig A, Capdevila Plaza L, Franco Esteve A (2004) Acute rejection and late renal transplant failure: risk factors and prognosis. Nephrol Dial Transplant 19(3):38–42

    Google Scholar 

  13. Hetzel GR, Klein B, Brause M, Westhoff A, Willers R, Sandmann W et al (2002) Risk factors for delayed graft function after renal transplantation and their significance for long-term clinical outcome. Transpl Int 15(1):10–16

    PubMed  Article  Google Scholar 

  14. Koning OH, Ploeg RJ, van Bockel JH, Groenewegen M, van der Woude FJ, Persijn GG et al (1997) Risk factors for delayed graft function in cadaveric kidney transplantation: a prospective study of renal function and graft survival after preservation with University of Wisconsin solution in multi-organ donors. European multicenter study group. Transplantation 63(11):1620–1628

    CAS  PubMed  Article  Google Scholar 

  15. Tranquart F, Lebranchu Y, Haillot O, Pourcelot D, Grezard O, Pourcelot L (1993) The use of perioperative Doppler ultrasound as a screening test for acute tubular necrosis. Transpl Int 6(1):14–17

    CAS  PubMed  Article  Google Scholar 

  16. Naesens M, Heylen L, Lerut E, Claes K, De Wever L, Claus F et al (2013) Intrarenal resistive index after renal transplantation. N Engl J Med 369(19):1797–1806

    CAS  PubMed  Article  Google Scholar 

  17. Chudek J, Kolonko A, Król R, Ziaja J, Cierpka L, Wiecek A (2006) The intrarenal vascular resistance parameters measured by duplex Doppler ultrasound shortly after kidney transplantation in patients with immediate, slow, and delayed graft function. Transplant Proc 38(1):42–45

    CAS  PubMed  Article  Google Scholar 

  18. Chow L, Sommer FG, Huang J, Li KC (2001) Power Doppler imaging and resistance index measurement in the evaluation of acute renal transplant rejection. J Clin Ultrasound 29(9):483–490

    CAS  PubMed  Article  Google Scholar 

  19. Wang HK, Chou YH, Yang AH, Chiou SY, Chiou HJ, Wu TH et al (2008) Evaluation of cortical perfusion in renal transplants: application of quantified power Doppler ultrasonography. Transplant Proc 40(7):2330–2332

    PubMed  Article  Google Scholar 

  20. Shebel HM, Akl A, Dawood A, El-Diasty TA, Shokeir AA, Ghoneim MA (2014) Power Doppler sonography in early renal transplantation: does it differentiate acute graft rejection from acute tubular necrosis? Saudi J Kidney Dis Transplant 25(4):733–740

    Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Luis Gustavo Modelli de Andrade.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Contti, M.M., Garcia, P.D., Kojima, C.A. et al. Quantified power Doppler as a predictor of delayed graft function after renal transplantation. Int Urol Nephrol 47, 405–412 (2015). https://doi.org/10.1007/s11255-014-0896-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-014-0896-6

Keywords

  • Power Doppler
  • Resistive index
  • AKI
  • Delayed graft function
  • Renal transplantation