Evolving Medical Imaging Techniques for the Assessment of Delayed Graft Function: A Narrative Review

Hysi, Eno; Kaur, Harmandeep; Young, Ann

doi:10.1177/20543581211048341

Cited by 3 publications

(1 citation statement)

References 199 publications

(146 reference statements)

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“…Therefore, there is a need for a convenient and accurate method to detect and predict DGF. Compared to other imaging modalities, CEUS better demonstrates microvascular circulation, tubular flow, and overall renal perfusion, providing a pathophysiological basis for its ability to better characterize early post-transplant renal parenchymal disease such as DGF [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

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

He¹,

Xu²,

Gong³

et al. 2023

Ultrasonography

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Purpose: The aim of this study was to quantify renal microcirculatory perfusion in braindead donors using contrast-enhanced ultrasonography (CEUS), and to establish an accurate, noninvasive, and convenient index for predicting delayed graft function (DGF) post-transplantation.Methods: In total, 90 brain-dead donor kidneys (training group, n=60; validation group, n=30) examined between August 2020 and November 2022 were recruited in this prospective study. CEUS was performed on the kidneys of brain-dead donors 24 hours before organ procurement and time-intensity curves were constructed. The main measures were arrival time, time to peak, and peak intensity of the kidney segmental arteries, cortex, and medulla. Recipients were divided into DGF and non-DGF groups according to early post-transplant graft function. The area under the receiver operating characteristic curve (AUC) was used to assess diagnostic performance.Results: The arrival time of the kidney segmental artery and cortex and the time interval between the time to peak of the segmental artery and cortex were identified as independent factors associated with DGF by multivariate stepwise regression analysis. A new index for the joint prediction model of three variables, the contrast-enhanced ultrasonography/Kidney Donor Profile index (CEUS-KDPI), was developed. CEUS-KDPI showed high accuracy for predicting DGF (training group: AUC, 0.91; sensitivity, 90.5%; specificity, 92.3%; validation group: AUC, 0.84; sensitivity, 75.0%; specificity, 92.3%).Conclusion: CEUS-KDPI accurately predicted DGF after kidney transplantation. CEUS may be a potential noninvasive tool for bedside examinations before organ procurement and may be used to predict early renal function after kidney transplants kidneys from donors after brain death.

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Section: Discussionmentioning

confidence: 99%

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

He¹,

Xu²,

Gong³

et al. 2023

Ultrasonography

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Application of ultrasound in early prediction of delayed graft function after renal transplantation

Jia,

Wang,

Wang

et al. 2024

Abdom Radiol

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In vivo assessment of pediatric kidney function using multi-parametric and multi-nuclear functional magnetic resonance imaging: challenges, perspectives, and clinical applications

De Mul,

Schleef,

Filler

et al. 2024

Pediatr Nephrol

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The conventional methods for assessing kidney function, such as glomerular filtration rate and microalbuminuria, provide only partial insight into kidney function. Multi-parametric and multi-nuclear functional resonance magnetic imaging (MRI) techniques are innovative approaches to unraveling kidney physiology. Multi-parametric MRI includes various sequences to evaluate kidney perfusion, tissue oxygenation, and microstructure characterization, including fibrosis—a key pathological event in acute and chronic kidney disease and in transplant patients—without the need for invasive kidney biopsy. Multi-nuclear MRI detects nuclei other than protons. 23Na MRI enables visualization of the corticomedullary gradient and assessment of tissue sodium storage, which can be particularly relevant for personalized medicine in salt-wasting tubular disorders. Meanwhile, 31P-MRS measures intracellular phosphate and ATP variations, providing insights into oxidative metabolism in the muscle during exercise and recovery. This technique can be useful for detecting subclinical ischemia in chronic kidney disease and in tubulopathies with kidney phosphate wasting. These techniques are non-invasive and do not involve radiation exposure, making them especially suitable for longitudinal and serial assessments. They enable in vivo evaluation of kidney function on a whole-organ basis within a short acquisition time and with the ability to distinguish between medullary and cortical compartments. Therefore, they offer considerable potential for pediatric patients. In this review, we provide a brief overview of the main imaging techniques, summarize available literature data on both adult and pediatric populations, and examine the perspectives and challenges associated with multi-parametric and multi-nuclear MRI. Graphical Abstract

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Evolving Medical Imaging Techniques for the Assessment of Delayed Graft Function: A Narrative Review

Cited by 3 publications

References 199 publications

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

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

Application of ultrasound in early prediction of delayed graft function after renal transplantation

In vivo assessment of pediatric kidney function using multi-parametric and multi-nuclear functional magnetic resonance imaging: challenges, perspectives, and clinical applications

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