Comparison the Diagnostic Value of Doppler Ultrasonography to Biopsy, in Evaluation of Post-transplant Complications and Kidney Function

Alireza Salmanipour, M. Ghadamzadeh, Seyed Morteza Bagheri, Roja Hajipour, Pedram Sadeghi, F. Vahedifard
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Abstract

Background Doppler ultrasonography can evaluate vascular and renal parenchymal disorders. In this study, color Doppler patterns in transplanted kidneys were compared with histological diagnosis to develop diagnostic models for transplanted kidney failure. Method 45 kidney transplant patients participated in this prospective study (16 suffered acute tubular necrosis (ATN), and 29 had transplant rejection). All patients had color-Doppler ultrasonography to measure kidney parameters and Doppler indices. Serum creatinine levels also assessed the transplanted kidney's function. Result Ultrasound showed a significant difference between the two groups in iliac and interlobar PSV. The ROC analysis showed a high diagnostic value of the iliac artery PSV, in distinguishing ATN from kidney transplant rejection. Serum creatinine level correlated directly with transplanted kidney volume, renal cortical thickness, and transplanted kidney length, and inversely with interlobar artery PSV and EDV. In graft rejection patients, the only significant inverse correlation was found between serum creatinine level and PSV of the iliac artery and EDV of the intrelobar artery. Discussion and conclusion The iliac artery PSV can differentiate between ATN and rejection after renal transplantation. Evaluation of renal metric parameters along with PSV and EDV of the interlobar artery (in patients with ATN) and iliac artery and interlobar artery (in transplant rejection) help determine renal dysfunction.
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多普勒超声与活检对肾移植术后并发症及肾功能的诊断价值比较
背景:多普勒超声可以评估血管和肾实质疾病。在本研究中,将移植肾的彩色多普勒图与组织学诊断进行比较,以建立移植肾衰竭的诊断模型。方法对45例肾移植患者进行前瞻性研究,其中16例发生急性肾小管坏死(ATN), 29例发生移植排斥反应。所有患者均行彩色多普勒超声检查肾脏参数及多普勒指数。血清肌酐水平也可评估移植肾的功能。结果超声检查显示两组患者髂、叶间PSV差异有统计学意义。ROC分析显示髂动脉PSV在区分ATN和肾移植排斥反应方面具有很高的诊断价值。血清肌酐水平与移植肾体积、肾皮质厚度、移植肾长度呈正相关,与叶间动脉PSV、EDV呈负相关。在移植排斥患者中,血清肌酐水平与髂动脉PSV和叶内动脉EDV之间存在显著负相关。讨论与结论髂动脉PSV可鉴别肾移植后ATN与排斥反应。评估肾脏指标参数以及叶间动脉(ATN患者)和髂动脉和叶间动脉(移植排斥)的PSV和EDV有助于确定肾功能不全。
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Comparison the Diagnostic Value of Doppler Ultrasonography to Biopsy, in Evaluation of Post-transplant Complications and Kidney Function Overview of global organ donation and transplantation in 2020 Development and prospect of clinical research on lung transplantation in post-COVID-19 era. Risk assessment of organ donation and procurement during COVID-19 epidemic Clinical analysis of 2019 coronavirus disease (COVID-19) on one case with living-related kidney transplantation/ 中华器官移植杂志
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