Ultrasonographic Finding in Transplanted Kidneys

Abstract

Doppler ultrasonography is a useful, non-invasive method of monitoring renal allograft dysunfction. 100 living donor transplant recipients had Doppler and real time ultrasound studies during the follow up period in the renal transplant clinic in Ahmed Gasim Hospital – Khartoum during the period from Dec 2003 to Dec. 2004. All patients had their transplantation in Sudan. The age of the patients was found to be ranged between 10-60 years, most of patients were males (85 patients) while females were (15 patients). Live related donors were 91 and non related living donars were nine. From this study we found that the causes of end stage renal diseae are due to to uncertain diagnosis account 55 patients followed by hypertension 21 patients, renal stone 10 patients, glomerulonephritis 4 patients; others uropathy, trauma, preclamatic toxeomia and chronic rejection. In this study 67 patients had dialysis for one year before renaltransplant , the rest had dialysis for one to three years. Resistive index was normal in 65 patients and increased in 35 patients. Based on resistive index, 85.5% of cases were diagnosed as normal kidney graft, when the resistive index was in normal range (0.5 – 0.7) increased reistive index (> 0.7 – 1.0) noticed in acute iii rejection 33.3%, chronic rejection 100%, acute tubular necrosis 30.8% and cyclosporine toxicity in 100%. From the study we found that ,when resistive index was normal (0.5- 0.7 ),blood urea was also normal (0-50 mg/dl) in 93.5 %, and when resistive index was high (0.7-1.0 ) ,blood urea was also high (100- 150mg/dl) in 83.3% . When serum creatinine with normal range (0.5-1.0 mg/dl), resistive index was normal (0.5-0.7 ) in 80 % and when serum creatinine was high (2.5-3.0 mg/dl ) resistive index was also high in 100% When the symptoms of patients compared with U/S diagnosis we found that patients with no complain , U/S reveal normal renal allograft in 75.9% , while patients with nausea, vomiting, abd pain, LL oedma had abnormal U/S findings. This showed that Doppler ultrasound was found to be useful and is complementary to laboratory investigation in the assessment of kidney graft.