Perfusion disturbances of kidney graft parenchyma evaluated with contrast-enhanced ultrasonography in the immediate period following kidney transplantation.

PURPOSE

Graft parenchyma perfusion disturbances (GPPD) in transplanted kidneys are common in the early postoperative period. Rapid and accurate diagnosis can guide proper treatment, preventing graft dysfunction.

METHODS

One hundred and eighty patients, who underwent kidney transplantation (KTx), were examined in the immediate postoperative period using real-time ultrasonography (B-mode) with color and power Doppler (US-CD/PD) and B-flow ultrasound, as well as with an additional protocol of contrast-enhanced ultrasonography (CE-US). Regions of GPPD were localized and measured. The number and size of these areas were compared between the two acquisition techniques. Follow-up examinations were carried out 6 months postoperatively.

RESULTS

CE-US revealed more GPPDs and showed them more precisely than the B+US-CD/PD/B-flow technique. Moreover, in the CE-US examination, ischemic foci had statistically significant higher echogenicity in comparison to normal parenchyma, were larger and better visualized (better circumscribed) than in B+US-CD/PD/B-flow.

CONCLUSION

CE-US allows the visualization of GPPD caused by occlusion of small arteries. It is a noninvasive, safe, real-time method, which has many advantages over standard B+US-CD/PD/B-flow examinations, and we recommend it as a routine diagnostic procedure in the early postoperative period following KTx.