Currently, US and the other modalities remain an indispensable tool for evaluating the kidney transplant recipient with graft dysfunction or post-transplant related complications.
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Images were kindly provided by Dr. Published online ahead of print. Publication date available at www. Skip to main content. Moving Points in Nephrology. You have access Restricted Access. Asif Sharfuddin. Summary Kidney transplantation can be associated with various complications that vary from vascular complications to urologic disorders to immunologic adverse effects.
Introduction Kidney transplant dysfunction can present with a rising serum creatinine level, decreasing urine output, and pain and tenderness over the graft, but often it is clinically asymptomatic and presents only with an isolated increase in serum creatinine. Figure 1. View this table: View inline View popup.
Table 1. Ultrasonography Color Doppler US is considered the first-line imaging modality to evaluate graft dysfunction because of its portability, rapid technique, and lack of radiation or toxic dye. Parenchymal Abnormalities In delayed graft function due to acute tubular necrosis ATN , US findings are nonspecific on gray-scale imaging. Figure 2. Figure 3. Perinephric Complications In the immediate postoperative period, hematomas are the most commonly encountered fluid collections. Vascular Complications Transplant renal artery stenosis TRAS is usually diagnosed within the first year after transplantation, with an incidence rate of 8.
Figure 4. Postbiopsy Complications Despite advances in noninvasive diagnostic tests and techniques, US-guided percutaneous core needle biopsy is still required in many cases of allograft dysfunction. Figure 5. Newer US Techniques Contrast-enhanced sonography CES with injected agitated microbubbles may have a much higher sensitivity and specificity and may be more useful for detecting infarction and cortical necrosis, particularly in ischemic renal transplants Computed Tomography CT provides superb anatomic detail of the graft and surrounding tissues, although its use is limited because of the requirement for nephrotoxic contrast agents.
Figure 6. Figure 7. Nuclear Medicine Imaging NM imaging of the allograft is a noninvasive, non-nephrotoxic tool to evaluate graft dysfunction, particularly in the early postoperative period. Figure 8. Magnetic Resonance Imaging MRI has increasingly become popular in kidney transplants and can be used as a second-line imaging technique if US or CT has been nondiagnostic in cases of parenchymal lesions or perinephric collections.
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Figure 9. Figure Research Techniques in Imaging Kidney Transplants Newer research modalities are constantly being developed to aid in noninvasive diagnosis of graft dysfunction.
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Acknowledgments Images were kindly provided by Dr. Footnotes Published online ahead of print. References 1. J Clin Ultrasound 33 : — , Acta Radiol 44 : 3 — 12 , Clin Transplant 27 : E — E , N Engl J Med : — , Nephrol Dial Transplant 20 : — , Can J Urol 12 : — , OpenUrl PubMed.
Wiseman AC : Polyomavirus nephropathy: A current perspective and clinical considerations. Am J Kidney Dis 54 : — , J Urol : 18 — 21 , Urol Int 69 : 99 — , J Endourol 24 : — , J Urol : — , Eur Urol 39 : — , J Pediatr Urol 9: —, Pediatr Transplant 11 : — , BJU Int 90 : — , Int J Urol 13 : — , Transplant Proc 28 : — , Transplant Proc 41 : — , Actas Urol Esp 19 : 8 — 14 , Am Surg 47 : — , Clin Transplant 24 : — , Am J Nephrol 30 : — , Clin Nephrol 71 : — , Radiology : — , J Ren Care 36 : — , Am J Transplant 6 : 95 — 99 , Nephrol Dial Transplant 21 : — , Nephron Clin Pract : c — c , Radiographics 25 : — , Semin Dial 18 : — , Clin Nephrol 74 : 39 — 45 , Clin Nephrol 43 : — , A comparison of two needle types and analysis of risk factors.
Transplantation 57 : — , Br J Surg 80 : — , Urol Int 48 : — , Ultrasound Q 22 : 53 — 66 , Clin Transplant 20 [ Suppl 17 ]: 51 — 54 , Ann Transplant 16 : 48 — 53 , Am J Hematol 81 : — , Transplant Proc 37 : — , Radiographics 29 : — , discussion — , Clin J Am Soc Nephrol 8 : — , Transplantation 94 : — , J Comput Assist Tomogr 36 : — , Evaluation of diagnosis with magnetic resonance angiography compared with color duplex sonography and arteriography.
Transplantation 62 : — , J Comput Assist Tomogr 25 : — , Camirand G : New perspectives in transplantation through intravital microscopy imaging. Curr Opin Organ Transplant 18 : 6 — 12 , Exp Clin Transplant 9 : — , Bol Asoc Med P R 97 : — , Previous Next.www.cantinesanpancrazio.it/components/vykynyd/127-copiare-rubrica.php
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Citation Tools. Request Permissions. Radiological Imaging of the Kidney Medical Radiology. Publisher: Springer , This specific ISBN edition is currently not available. View all copies of this ISBN edition:. Synopsis About this title This book, now in its second edition, provides a comprehensive analysis of imaging of the kidneys, upper urinary tract, and ureters, covering the normal anatomy and anatomic variants as well as all renal and urinary system pathologies.
This worthy objective has been achieved nicely in this book. Nephrologists, urologists, radiologists, oncologists, medical students, and fellows in these disciplines are the intended audience.
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