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Detection of transplant renal artery stenosis: determining normal velocities at the renal artery anastomosis

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Abstract

Purpose

Renal artery anastomosis peak systolic velocity (RAA PSV) exceeding 250 cm/s and a ratio of the renal artery to the adjacent external iliac artery (RAA:EIA) exceeding 1.8 historically suggest significant transplant renal artery stenosis (TRAS). However, the range of RAA PSV in transplants without TRAS has not been established.

Methods

A retrospective review of renal transplants at a single institution over 5 years was performed identifying patients without graft dysfunction, failure, or refractory hypertension. RAA PSV obtained during interval postoperative sonograms was recorded.

Results

Of 1141 patients, 844 met the inclusion criteria. Mean RAA PSV for 377 patients evaluated within 2 days of transplant measured 195 cm/s; RAA PSV exceeded 250 cm/s in 97 patients (26%). Mean RAA PSV for 820 patients evaluated 1-month post-transplant measured 206 cm/s; RAA PSV exceeded 250 cm/s in 224 patients (27%). Mean RAA PSV for 785 patients evaluated 4-month post-transplant measured 203 cm/s; RAA PSV exceeded 250 cm/s in 201 patients (26%). Mean RAA PSV for 766 patients evaluated 1-year post-transplant measured 189 cm/s; RAA PSV exceeded 250 cm/s in 141 patients (18%). At each of the given time points, 24%–34% of normal patients had RAA-to-EIA ratios greater than 1.8.

Conclusion

Approximately, 26% of patients without TRAS have RAA PSV > 250 cm/s in the first 9 months, and 18% do at 1 year. Similar findings also occurred with regards to the RAA-to-EIA ratio threshold of 1.8. In isolation, a PSV over 250 cm/s or 1.8 ratio threshold for suspicion of TRAS will lead to a large number of false-positive assessments.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Mayo Clinic Hospital, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA

    Kristin A. Robinson, J. Scott Kriegshauser, Nirvikar Dahiya, Scott W. Young, Christopher D. Czaplicki & Maitray D. Patel

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  1. Kristin A. Robinson
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  2. J. Scott Kriegshauser
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  3. Nirvikar Dahiya
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  4. Scott W. Young
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  5. Christopher D. Czaplicki
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  6. Maitray D. Patel
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Correspondence to Kristin A. Robinson.

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No funding was received for this study.

Conflict of Interest

Drs. Kristin Robinson, J. Scott Kriegshauser, Nirvikar Dahiya, Scott Young, Chris Czaplicki, and Maitray Patel declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Robinson, K.A., Kriegshauser, J.S., Dahiya, N. et al. Detection of transplant renal artery stenosis: determining normal velocities at the renal artery anastomosis. Abdom Radiol 42, 254–259 (2017). https://doi.org/10.1007/s00261-016-0876-7

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  • DOI: https://doi.org/10.1007/s00261-016-0876-7

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