Duplex ultrasound in the assessment of renal transplant complications

Murphy, Alana M; Robertson, Ross

doi:10.1016/s0009-9260(87)80051-x

Cited by 40 publications

(29 citation statements)

References 11 publications

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“…It can be enhanced by pulsed Doppler ultrasound, which, in combination with colour-coded flow, allows for a precise evaluation of vascular supply to the graft [3]. Normal flow in the vessels of a transplant is characterised by a rapid and sharp upstroke during the systolic phase followed by a gradual 'ski slope' diastolic descent as determined by Doppler imaging [4]. A transplanted kidney is a low resistance system with a continuous diastolic flow, about 30% of peak systolic flow.…”

Section: Ultrasoundmentioning

confidence: 99%

“…A variety of sophisticated indexes has been proposed to detect even small changes in peripheral resistance. The most widely used is the Resistive Index of Pourcelot (RI) [4]: (maximum systolic frequency shift -minimum diastolic frequency shift)/(maximum systolic frequency shift). Another common index is the Gosling and Kind Pulsatility Index (PI) [4]: (maximum systolic frequency shift -minimum diastolic frequency shift)/(mean frequency shift).…”

Section: Ultrasoundmentioning

confidence: 99%

“…An increased peripheral impedance will cause a rise in RI or PI. In initial studies, episodes of acute rejections were detected with a sensitivity of 100% [4]. However, the study population had been selected with only one case of acute tubular necrosis as compared to 14 episodes of acute rejection.…”

Section: Ultrasoundmentioning

confidence: 99%

See 2 more Smart Citations

Non-Invasive Monitoring of Graft Dysfunction after Renal Transplantation

Heemann¹,

Lütkes²,

Kribben³

et al. 1998

Transfus Med Hemother

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Section: Ultrasoundmentioning

confidence: 99%

Section: Ultrasoundmentioning

confidence: 99%

See 1 more Smart Citation

Non-Invasive Monitoring of Graft Dysfunction after Renal Transplantation

Heemann¹,

Lütkes²,

Kribben³

et al. 1998

Transfus Med Hemother

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“…Tubulitis was present in up to 42.2% of the tubular cross-sections. This suggests that severe chronic ischemia, similar to allograft rejection [17][18][19][20], may induce inflammatory cells to invade the tubular epithelium. Indeed, Truong et al [21] observed more pronounced tubulitis in patients with transplant rejection than in those with glomerulonephritis or tubulointerstitial nephritis of'the native kidney.…”

Section: Banff Classification and Outcomementioning

confidence: 99%

Renal allograft rejection in children and young adults: the Banff classification

et al. 1995

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In the Banff classification, arteritis and tubulitis are regarded as the principal histological lesions indicating acute renal allograft rejection. To test this claim, we examined 51 biopsies obtained from 21 children and young adults with transplant rejection. Two reviewers, blind to the clinical course, graded the biopsies according to the Banff scheme. In patients without significant tubulitis (borderline changes), rejection tended to be reversed easily (88%), often with methylprednisolone pulse (52%). In patients with arteritis or significant tubulitis (Banff I-III), rejection was reversed in only 23% (P < 0.001), in 9% with steroids, and in 14% with OKT3. Salvage of the graft was achieved in 26 of 35 (74%) with a score < 5 but in only 1 of 12 (8%) with a score > or = 5 (P < 0.001). All 6 patients with vasculitis lost their grafts despite methylprednisolone pulse and OKT3. We conclude that the Banff classification predicts accurately the outcome of renal allograft rejection in children and may aid in choosing appropriate therapy.

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“…Resistance to blood fl ow expressed as an arterial resistance index has been found to be of prognostic value in terms of downstream perfusion for organs such as the kidney and gastrointestinal tract in infants, with values >1.0 being indicative of a poor prognosis. [1][2][3][4] Resistance to arterial fl ow in the liver can be assessed by ultrasonography (US) 5 and expressed as the hepatic artery resistance index (HRI). 6 In the present study, we examined the diagnostic and prognostic signifi cance of the HRI in children with BA.…”

Section: Introductionmentioning

confidence: 99%