Abstract
Kidney transplantation is the best replacement therapy for patients with end stage renal disease. However, despite the surgical advances and a better management of immunosuppression, many surgical complications may arise during the immediate and long-term follow. Sonography is the most important imaging technique for monitoring the graft function and for the diagnosis of surgical complications. It is easy to perform and allows a timely diagnosis of most surgical complications of kidney transplantation. Early detection and management of vascular and parenchymal anomalies could be extremely useful to improve the graft survival. In this chapter we explore the most frequent surgical complications of kidney transplantation, with a special focus on the sonograhic evaluation.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Herman H, Irshad A, Ackerman S, Shazly M. Diagnostic challenges in kidney transplantation. In: Veroux M, Veroux P, editors. Kidney Transplantation: Challenging the future. UAE: Bentham Science Editor; 2012. p. 168–85.
Veroux M, Corona D, Veroux P. Kidney transplantation: future challenges. Minerva Chir. 2009;64:75–100.
Irshad A, Ackerman SJ, Campbell AS, Anis M. An overview of renal transplantation: current practice and use of ultrasound. Semin Ultrasound. 2009;30:298–314.
Sharfuddin A. Imaging evaluation of kidney transplant recipients. Semin Nephrol. 2011;31:259–71.
Martino P, Lucarelli G, Palazzo S, Tedeschi M, Impedovo SV, Di Lorenzo V, Ditonno P, Battaglia M, Selvaggi FP. Surgical complications of renal transplantation: ultrasound diagnosis. Arch Ital Urol Androl. 2010:221–5.
Jimenez C, Lopez MO, Gonzales E, Selgas R. Ultrasonography in kidney transplantation: values and new developments. Transplant Rev. 2009;23:209–13.
Heine Gh GMK, Ulrich C, Kohler H, Girndt M. Renal Doppler resistance indices are associated with systemic atherosclerosis in kidney transplant recipients. Kidney Int. 2005;68:878–85.
Radermacher J, Mengel M, Ellis S, et al. The renal arterial resistance index and renal allograft survival. N Engl J Med. 2003;349:115–24.
Singh AK, Sahani DV. Imaging of the renal donor and transplant recipient. Radiol Clin N Am. 2008;46:79–93.
Fischer T, Filimonow S, Dieckhöfer J, et al. Improved diagnosis of early kidney allograft dysfunction by ultrasound with echo enhancer: a new method for the diagnosis of renal perfusion. Nephrol Dial Transplant. 2006;2:2921–9.
Grzelak P, Kurnatowska I, Nowicki M, Muras K, Podgórski M, Strzelczyk J, Stefańczyk L. Detection of transplant renal artery stenosis in the early postoperative period with analysis of parenchymal perfusion with ultrasound contrast agent. Ann Transplant. 2013;18:187–94.
Stenberg B, Chandler C, Wyrley-Birch H, Elliott ST. Post-operative 3-dimensional contrast-enhanced ultrasound (CEUS) versus Tc99m-DTPA in the detection of post-surgical perfusion defects in kidney transplants - preliminary findings. Ultraschall Med. 2014;35:273–8.
Tublin ME, Dodd GDIII. Sonography of renal transplantation. Radiol Clin N Am. 1995;33:447–59.
Pozniak MA, Dodd GD, Kelcz F. Ultrasonographic evaluation of renal transplantation. Radiol Clin N Am. 1992;30:1053–66.
Noorbala MH, Gholamrezaie HR. Study of surgical complications between primary and secondary renal transplants. Transplant Proc. 2005;37:2154–6.
Sutherland T, Temple F, Chang S, Hennessy O, Lee W-K. Sonographic evaluation of renal transplant complications. J Med Imag Radiat Oncol. 2010;54:211–8.
Borrego J, Burgos FJ, Galmes I, et al. Surgical complications in 479 renal transplantations. Actas Urol Esp. 1994;18:253–7.
Preda A, Van Dijk LC, Van Oostaijen JA, Pattynama PMT. Complication rate and diagnostic yield of 515 consecutive ultrasound guided biopsies of renal allografts and native kidneys using a 14-gauge Biopty gun. Eur Radiol. 2003;13:527–30.
Granata A, Clementi S, Londrino F, Romano G, Veroux M, Florini F, Fatuzzo P. Renal transplant vascular complications: the role of Doppler ultrasound. J Ultrasound. 2015;18:101–7.
Hurst Fp AKC, Neff RT, et al. Incidence, predictors and outcomes of transplant renal artery stenosis after kidney transplantation: analysis of USRDS. Am J Nephrol. 2009;30:459–67.
Henning BF, Kuchlbauer S, Boger CA, et al. Percutaneous transluminal angioplasty as first-line treatment of transplant renal artery stenosis. Clin Nephrol. 2009;71:543–9.
Mangray M, Vella JP. Hypertension after kidney transplantation. Am J Kidney Dis. 2011;57:331–41.
Weir MR, Salzberg DJ. Management of hypertension in the transplanted patient. J Am Soc Hypertens. 2011;5:425–32.
De Morais RH, Muglia VF, Mamere AE. Duplex Doppler sonography in transplant renal artery stenosis. J Clin Ultrasound. 2003;31:135–41.
Gao J, Li J, Meng-Su X, et al. Color duplex sonography in severe transplant renal artery stenosis: a comparison of end-to-end and end-to-side arterial anastomoses. Clin Imaging. 2009;33:116–22.
Grenier N, Claudon M, Trillaud H, et al. Noninvasive radiology of vascular complications in renal transplantation. Eur Radiol. 1997;7:385–91.
Brown ED, Chen MY, Wolfman NT, Ott DJ, Watson NE Jr. Complications of renal transplantation: evaluation with US and radionuclide imaging. Radiographics. 2000;20:607–22.
Akbar SA, Jafri SZ, Amendola MA, Madrazo BL, Salem R, Bis KG. Complications of renal transplantation. Radiographics. 2005;25:1335–56.
Veroux M, Corona D, Giuffrida G, Gagliano M, Giaquinta A, Tallarita T, Zerbo D, Cappellani A, Sorbello M, Veroux P. A rare cause of iliocaval thrombosis in kidney transplantation. Transplant Proc. 2009;41(4):1405–6.
Veroux M, Veroux P, Puliatti C, Fiamingo P, Macarone M, Cappello D. Renal allograft rupture caused by acute tubular necrosis. Chir Ital. 2003;55(5):753–5.
Elsayes KM, Menias CO, Willat J, Azar S, Harvin HJ, Platt JF. Imaging of renal transplant: utility and spectrum of diagnostic findings. Curr Probl Diagn Radiol. 2011;40:127–39.
Martinez T, Palomares M, Bravo JA, et al. Biopsy-induced arteriovenous fistula and venous aneurysm in a renal transplant. Nephrol Dial Transplant. 1998;13:2937–9.
Barley FL, Kessel D, Nicholson T, et al. Selective embolization of large symptomatic iatrogenic renal transplant arteriovenous fistula. Cardiovasc Interv Radiol. 2006;29:1084–7.
Yablon Z, Recupero P, McKenna J, Vella J, Parker MG. Kidney allograft biopsy: timing to complications. Clin Nephrol. 2010;74:39–45.
Gainza FJ, Minguela I, Lopez-Vidaur I, Ruiz LM, Lampreade I. Evaluation of complications due to percutaneous renal biopsy in allografts and native kidneys with color-coded Doppler sonography. Clin Nephrol. 1995;45:303–8.
Nakatani T, Uchida J, Han YS, et al. Renal allograft arterio-venous fistula and large pseudoaneurysm. Clin Transpl. 2003;17:9–12.
Pearl AL. Diagnostic imaging in kidney transplantation. In: Danovitch GM, editor. Handbook of kidney transplantation. Philadelphia: Lippincot Williams Wilkins; 2007. p. 291–310.
Gogus C, Yaman O, Soygur T, Beduk Y, Gogus O. Urological complications in renal transplantation: long-term follow-up of the Woodruff ureteroneocystostomy procedure in 433 patients. Urol Int. 2002;69:99–101.
Kocak B, Baker TB, Koffron AJ, Leventhal JR. Ureteral complications in the era of laparoscopic living donor nephrectomy: do we need to preserve the gonadal vein with the specimen? J Endourol. 2010;24:247–51.
Nankivell BJ, Chapman JR. Chronic allograft nephropathy: current concepts and future directions. Transplantation. 2006;81:643–54.
Granata A, Di Nicolò P, Scarfia VR, Insalaco M, Lentini P, Veroux M, Fatuzzo P, Fiorini F. Renal transplantation parenchymal complications: what Doppler ultrasound can and cannot do. J Ultrasound. 2014;18:109–16.
Veroux M, Corona D, Giuffrida G, Gagliano M, Tallarita T, Giaquinta A, Zerbo D, Cappellani A, Veroux PF. Acute renal failure due to ureteral obstruction in a kidney transplant recipient with Candida albicans contamination of preservation fluid. Transplant Infect Dis. 2009;11:266–8.
Granata A, Clementi S, Londrino F, Romano G, Veroux M, Fiorini F, Fatuzzo P. Renal transplant vascular complications: the role of Doppler ultrasound. Ultrasound. 2014;18(2):101–7. https://doi.org/10.1007/s40477-014-0085-6.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Veroux, M., Zerbo, D., Corona, D., Sinagra, N., Veroux, P. (2021). Sonographic Evaluation of Surgical Complications of Kidney Transplantation. In: Granata, A., Bertolotto, M. (eds) Imaging in Nephrology. Springer, Cham. https://doi.org/10.1007/978-3-030-60794-4_17
Download citation
DOI: https://doi.org/10.1007/978-3-030-60794-4_17
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-60792-0
Online ISBN: 978-3-030-60794-4
eBook Packages: MedicineMedicine (R0)