Garcia-Covarrubias L, Martinez A, Morales-Buenrostro L E, Bezaury P, Alberu J, Garcia A, Vilatoba M, Gabilondo B
Department of Transplantation and Radiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Mexico City, Mexico.
Transplant Proc. 2010 Jan-Feb;42(1):262-5. doi: 10.1016/j.transproceed.2009.11.027.
In our center, a Doppler ultrasound (DU) is performed at 5 days after transplantation. The normal upper limit of flow velocity (FV) in the renal artery is 200-250 cm/s. The resistance index (RI) is considered elevated when >0.8. Elevation of the RI can be shown in all the forms of graft dysfunction.
The objective of this study was to evaluate the capacity of the DU to predict the prognosis of graft function and histological damage at 1 year.
We examined a retrospective cohort of patients undergoing renal transplantation between January 2004 and May 2007. The renal function was evaluated with serum creatinine measurements and glomerular filtration rate (GFR) estimates by the quadratic Modification of Diet in Renal Disease study equation. The biopsy specimen was evaluated according to the Banff 1997 classification.
The overall average age was 35 years, and 58% of the subjects were men. Eight cases (25.8%) showed abnormal DU. The Delta among those with normal DU was -0.94 versus 0.27 +/- 0.39 with abnormal DU (P < .005). There was no significance as far as the biopsy at 1 year.
Renal DU allows physicians to suspect complications at the first posttransplantation year. It shows a tendency to elevated blood pressure, as well as increased deterioration of renal function over the first year.
在我们中心,移植术后5天进行多普勒超声(DU)检查。肾动脉血流速度(FV)的正常上限为200 - 250厘米/秒。当阻力指数(RI)>0.8时被认为升高。RI升高可出现在所有形式的移植物功能障碍中。
本研究的目的是评估DU预测1年时移植物功能预后和组织学损伤的能力。
我们检查了2004年1月至2007年5月期间接受肾移植患者的回顾性队列。通过肾病饮食改良研究方程的二次方程估算血清肌酐测量值和肾小球滤过率(GFR)来评估肾功能。根据1997年班夫分类法评估活检标本。
总体平均年龄为35岁,58%的受试者为男性。8例(25.8%)显示DU异常。正常DU者的变化值为 - 0.94,而异常DU者为0.27±0.39(P <.005)。就1年时的活检而言无显著差异。
肾DU使医生能够在移植后第一年怀疑并发症。它显示出血压升高的趋势,以及第一年肾功能恶化加剧的情况。