Significance of elevated transplant renal artery velocities in the postoperative renal transplant patient

Autor:	Drew M. Caplin, Craig R. Greben, Eric J. Gandras, Mala Sachdeva, Mark Blum, Gene F. Coppa, Kellie Calderon, Catherine D’ Agostino, Manuel Villa, Elizabeth M. Olsen, Leandro Lumermann, Michael Kuncewitch, Daniel Putterman, Madhu Bhaskaran, Eric Siskind, Kenar D. Jhaveri, Ernesto P. Molmenti, John S. Pellerito, Asha Alex, Richard Tyrell, Pamela Lombardi
Rok vydání:	2013
Předmět:	Male medicine.medical_specialty Renal Artery Obstruction Postoperative Complications Renal Artery medicine.artery Internal medicine medicine Humans Renal artery Kidney transplantation Transplantation medicine.diagnostic_test business.industry Ultrasonography Doppler medicine.disease Kidney Transplantation Surgery Stenosis surgical procedures operative Renal blood flow Angiography Cardiology Female business Perfusion Blood Flow Velocity Follow-Up Studies
Zdroj:	Clinical Transplantation. 27:E157-E160
ISSN:	0902-0063
DOI:	10.1111/ctr.12075
Popis:	Introduction Non-invasive imaging studies can provide visualization of allograft perfusion in the postoperative evaluation of newly transplanted renal allografts. Aim The purpose of our study was to evaluate the significance of elevated renal artery velocities in the immediate postoperative period. Methods Peak systolic velocities (PSVs) were obtained in the transplanted renal artery of 128 patients immediately after transplantation. Repeat allograft Doppler ultrasonography was performed on patients with elevated values. Results Of the 128 patients, 57 (44.5%) had severely elevated Doppler velocities >400 cm/s on the initial studies. Three patients within this category had persistently elevated values of >400 cm/s, warranting angiographic visualization of the renal vessels. Stent placement within the transplanted renal artery was required in two of these patients. There was normalization of the PSV in the remaining patients. Conclusions Routine allograft Doppler ultrasonography in the immediate postoperative period allows for visualization of allograft perfusion. Elevated renal artery velocities in the immediate postoperative period do not necessarily represent stenosis requiring intervention. Failure of the PSV to normalize may require further intervention, and angiography continues to be the gold standard.
Databáze:	OpenAIRE
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