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

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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.

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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

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Urology, University of Navarra Clinic, P.O. Box 4209, 31008, Pamplona, Spain

    Javier Barba, José Enrique Robles, Anibal Rincón, David Rosell, Juan Javier Zudaire, José María Berian & Ignacio Pascual

  2. Department of Urology, Miguel Servet Hospital, Zaragoza, Spain

    Jorge Rioja

  3. Radiology Service, University of Navarra Clinic, Pamplona, Spain

    Alberto Benito

  4. Department of Nephrology, University of Navarra Clinic, Pamplona, Spain

    Pedro Errasti

Authors
  1. Javier Barba
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  2. Jorge Rioja
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  3. José Enrique Robles
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  4. Anibal Rincón
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  5. David Rosell
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  6. Juan Javier Zudaire
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  7. José María Berian
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  8. Ignacio Pascual
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  9. Alberto Benito
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  10. Pedro Errasti
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Correspondence to Javier Barba.

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Barba, J., Rioja, J., Robles, J.E. et al. Immediate renal Doppler ultrasonography findings (<24 h) and its association with graft survival. World J Urol 29, 547–553 (2011). https://doi.org/10.1007/s00345-011-0666-3

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  • DOI: https://doi.org/10.1007/s00345-011-0666-3

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