Increased peak systolic velocity in the renal artery of paediatric kidneys transplanted to adult recipients.

BACKGROUND

Paediatric kidneys transplanted to adult recipients increase in size after transplantation. It is unknown if the renal artery diameter increases concomitantly with the kidney. This study was performed to assess if peak systolic velocity (PSV) in the renal arteries of paediatric kidneys transplanted to adult recipients is comparable to PSV in the renal arteries of adult kidneys transplanted to adult recipients. Subjects and methods. Fifteen adult patients with paediatric renal transplants were examined with ultrasound Doppler and compared with a control group of adult recipients with adult transplants. MR angiography (MRA) or intra-arterial angiography (IA) was performed in patients with elevated PSV. MRA renal diameters of the paediatric transplants were compared with adult transplants.

RESULTS

The mean maximum PSV of the paediatric kidneys was 2.0 m/s (0.9-3.8), almost twice compared with the adult grafts transplanted to adult recipients, 1.1 m/s (0.7-1.6), P < 0.001. Seven paediatric transplants had a PSV >1.8 m/s, but only two had significant stenosis on MRA/IA. All patients had excellent blood pressure and renal function. The mean diameter of the paediatric renal arteries was 4.1 mm (3.4-6.0), whereas the mean for the adult renal arteries was 5.6 mm (4.8-6.9), P = 0.02.

CONCLUSION

Adult recipients of paediatric kidneys have significantly higher maximum PSV in the renal artery compared to adult recipients of adult grafts. The significantly smaller renal artery diameter might explain the high PSV. A PSV >1.8 m/s by itself does not necessarily indicate transplant renal artery stenosis in paediatric kidneys transplanted to adult recipients, but should be related to clinical findings.