Sonography: A useful tool to detect the mechanical causes of renal transplant dysfunction

✍ Scribed by Gottlieb, Ronald H.; Voci, Susan L.; Cholewinski, Scott P.; Hartley, Donna F.; Rubens, Deborah J.; Orloff, Mark S.; Bronsther, Oscar L.

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 456 KB
• Volume: 27
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/(sici)1097-0096(199907/08)27:6<325::aid-jcu3>3.0.co;2-4

✦ Synopsis

Purpose:

The purpose of this study was to evaluate the utility of sonography in distinguishing between mechanical and nonmechanical causes for renal transplant dysfunction.

Methods:

We reviewed all ultrasound examination reports (n = 286) for 63 consecutive patients who received 64 renal transplants. we assessed the sensitivity and specificity of different degrees of hydronephrosis (mild, moderate, or severe) in detecting urinary tract obstruction; different volumes of new or increasing peritransplant fluid in detecting urine leaks; different total volumes of peritransplant fluid in predicting significant compression of the transplant; and doppler vascular criteria for predicting arterial and venous occlusion.

Results:

All mechanical complications were detected (100% sensitivity) with specificities of 91.9% for ureteral obstruction (criterion, moderate hydronephrosis), 83.4% for urine leaks (criterion, any new fluid or any increase), 91.4% for fluid collections that compressed the transplant (criterion, > 100 ml), and 100% for vascular occlusion (criteria, no flow for arterial occlusion; no venous flow and reversal of arterial flow during diastole for venous occlusion).

Conclusions:

Sonography is very useful in distinguishing between mechanical and nonmechanical causes for renal transplant dysfunction. it has high sensitivity and acceptable specificity in this setting.