Contrast‐Enhanced Ultrasonography Value for Early Prediction of Delayed Graft Function in Renal Transplantation Patients

Abstract

Objectives-Delayed graft function (DGF) is a common early complication after kidney transplantation. The aim of the present study was to evaluate the value of contrast-enhanced ultrasonography (CEUS) in the early prediction of DGF after kidney transplantation.Methods-A total of 89 renal transplant recipients were retrospectively enrolled and divided into DGF group or normal graft function (NGF) group according to the allograft function. Conventional Doppler ultrasound and CEUS examination data on the first postoperative day were collected and analyzed.Results-The resistive indices of segmental and interlobar artery in the DGF group were significantly higher than those in the NGF group (0.71 AE 0.17 versus 0.63 AE 0.08, P = .006; 0.70 AE 0.16 versus 0.62 AE 0.08, P = .004, respectively). The patients experiencing DGF had significantly lower PI-c (14.7 dB AE 6.1 dB versus 18.5 dB AE 3.3 dB, P = .001) and smaller AUC-c (779.8 AE 375.8 dBÁseconds versus 991.0 AE 211.7 dBÁseconds, P = .003), as well as significantly lower PI-m (12.6 dB AE 5.9 dB versus 15.9 dB AE 3.9 dB, P = .006), shorter MTT-m (30.7 AE 9.4 seconds versus 36.3 AE 7.1 seconds, P = .01), and smaller AUC-m (P = .007). Multivariate analysis demonstrated that PI-c, AUC-c, and MTT-m were independent risk factors for DGF. The area under the receiver operating characteristic curve values of the combined predicted value (PI-c + MTT-m, PI-c + AUC-c + MTT-m) of DGF incidence were bigger than that of PI-c, AUC-c, or MTT-m.Conclusions-CEUS parameters of the cortex and medulla have a good value for an early prediction of DGF after renal transplantation.

Contrast-enhanced ultrasonography-based renal blood perfusion in brain-dead donors predicts early graft function

“…Under normal physiological conditions, the blood supply to the KC remains within a relatively stable range; as kidney insufficiency increases, cortical perfusion gradually decreases, the flow of contrast medium into the KC decreases, and the TTP is prolonged. This process is consistent with that described in the recent study by Song et al [ 28 ], in which PI of the cortex had higher specificity as an independent predictor of DGF than the specificity of other parameters.…”

Delayed graft function: current status and future directions

“…Contrast-enhanced ultrasonography (CEUS) has been shown to predict DGF as early as postoperative day 1. Song et al [36 ▪▪ ] in their study of 89 KTRs, found that several vascular, cortical, and medullary parameters were predictive of DGF and that this predictive ability was summative. The University of Utah is actively recruiting for a similar study (NCT02911714)…”