Color Doppler indexes in early phase after kidney transplantation and their association with kidney function on six month follow up

Abstract

Background:Doppler ultrasonography (DU) and measurement of its indexes, resistive index (RI) and pulsatility index (PI), is used to investigate transplanted kidney hemodynamic status and function. The aim of this study was to determine the correlation between Doppler indexes in the early phase after transplantation with long-term transplanted kidney function.Materials and Methods:In this cross-sectional study on 38 newly kidney transplant patients, we performed DU with assessment of its indexes within 48 hours, 1 week, and 6 months after kidney transplantation. Serum creatinine after stability and 6 months after kidney transplantation were assessed. Cyclosporine level was measured 1 week after kidney transplantation and compared with DU indexes.Results:About 71% of kidney transplanted patients reached their normal initial creatinine level(cr<1.5 mg/ dl) and 28% of all patients were involved in kidney dysfunction after 6 months (increase in basic creatinine level more than 25%).There was no significant difference between mean RI and PI in patients with normal and disturbed kidney function based on creatinine level in early posttransplantation period but there was linear correlation between mean RI and PI within 48 hours and 1 week with kidney function after 6 months. Also no association between cyclosporine level and RI and PI was shown. There was a direct association between age and the levels of RI and PI 6 months after transplantation.Conclusion:This study suggests assessment of RI and PI in early period after transplantation and can be used as predictive parameters for long-term function of transplanted kidney and RI more than 0.80 in early phase after transplantation has an acceptable sensitivity and specificity to predict long-term kidney dysfunction.

Determinants of the serial changes in measurements of renal allograft Doppler resistive index in the first postoperative month

“…Taken together, these findings corroborate that the serial increase in RI is strongly associated with the development of a more severe type of ischemia reperfusion injury. In line with these results, several studies suggest a relationship between increased RI and delayed graft function, acute rejection, histologic lesions on biopsy, and transplant failure 7 , 16 , 21 - 25 . In agreement with the results of the current study, in which patients with decrease in RI (Group I) had better SCr results and lower likelihood to require dialysis in the observed period, other studies found a direct relationship between RI and serum creatinine 8 , 26 , 27 .…”

Early Ultrasound Assessment of Renal Transplantation as the Valuable Biomarker of Long Lasting Graft Survival: A Cross-Sectional Study

“…Barba et al ( 13 ) found that RI measured as early as 24hr after surgery can predict the long-term graft survival. Adibi et al ( 14 ) showed that early determination of RI and PI could predict long-term graft function in kidney transplant recipients. Kramann et al ( 15 ) published a paper in which they described that only RIs evaluated between 12-18 months after transplantation can predict long-term graft function.…”