Abstract

The main diagnostic method of renal graft dysfunction is Colour Doppler ultrasound with the use of spectra evaluation of blood fl ow within the renal arteries and intrarenal arteries. Ultrasound with contrast medium-US-CM enhances possibilities of this diagnostic. The aim of the study was to evaluate the usefulness of US-CM in assessment of renal graft perfusion in 18 kidney allograft recipients at 5-10 days after transplantation. Patients underwent pulse inversion sonography of the graft during intravenous injections of 2.4 ml SonoVue (Bracco-Altana). Images were assessed quantitatively using computer software to compare the time to peak contrast enhancement effect in the renal cortex with renal pyramid. The results were compared to Doppler ultrasonography of renal arteries and eGFR (MDRD). A correlation was found between eGFR and blood flow parameters within the renal arteries, as well as between flow time of the contrast medium from artery within the renal hilus to the renal cortex. Increase in eGFR correlated with subsequent improvement in graft function (r=-0.806; P=0.01), and inversely, elevated RI of renal artery was related to subsequent delayed graft function (r=0.544; P=0.029). The negative correlation was found between eGFR and renal artery RI, and between eGFR and time from renal artery contrasting to maximal contrast enhancement of renal pyramids. Negative correlation was found as well between eGFR and time difference of contrast enhancement of cortex and pyramids. US-CM enhances the efficiency of ultrasound diagnostics of the renal graft and may be used as a predictor of graft function in the early post transplant period.

Keywords: Kidney Transplantation, Organ Perfusion