Rasmussen K, Pedersen E
Department of Nephrology, Herlev Hospital, University of Copenhagen, Denmark.
Scand J Clin Lab Invest. 1990 Feb;50(1):57-61. doi: 10.1080/00365519009091565.
Thirty-six consecutively transplanted renal allograft patients were prospectively monitored with ultrasound-Doppler examinations three times weekly during the first 3 weeks after transplantation. Although triple-immunosuppressive therapy consisting of cyclosporin A, azathioprine and prednisolone was used, acute rejection occurred in 11 patients. Nine patients had immediate onset of graft function and no rejection. Ten patients had acute tubular necrosis (ATN) without any signs of rejection and were treated with dialysis for 1-3 weeks after transplantation. Thrombosis of the renal artery was diagnosed in four patients. During rejection episodes pulsatility index (PI) was above normal range in all patients. In patients with mild to moderate ATN and PI was normal throughout the clinical course whereas two patients with severe ATN but no signs of rejection in the kidney biopsy also had high PI. It is concluded that serial Doppler velocity examination after kidney transplantation is a non-invasive, cheap and reliable method for monitoring of the graft. The method can be used in the early diagnosis of rejection, and it is of special value in monitoring grafts without function.
36例连续接受肾移植的患者在移植后的前3周内每周接受3次超声多普勒检查进行前瞻性监测。尽管使用了由环孢素A、硫唑嘌呤和泼尼松龙组成的三联免疫抑制疗法，但仍有11例患者发生急性排斥反应。9例患者移植肾功能立即恢复且未发生排斥反应。10例患者发生急性肾小管坏死（ATN），无任何排斥反应迹象，移植后接受了1 - 3周的透析治疗。4例患者被诊断为肾动脉血栓形成。在排斥反应发作期间，所有患者的搏动指数（PI）均高于正常范围。轻度至中度ATN患者在整个临床过程中PI正常，而2例严重ATN但肾活检无排斥反应迹象的患者PI也较高。结论是肾移植后连续多普勒速度检查是一种无创、廉价且可靠的移植监测方法。该方法可用于排斥反应的早期诊断，对无功能移植肾的监测具有特殊价值。
