Sonography of renal transplantation.

Marked improvements in graft survival have made renal transplantation the treatment of choice for end-stage renal disease. Ultrasound, because it is an accurate and noninvasive screening examination for graft dysfunction, clearly has had an impact upon graft survival rates. Gray scale sonography easily detects hydronephrosis and perinephric fluid collections. Vascular complications of transplantation--AVFs, pseudoaneurysms, arterial/venous thrombosis and stenosis--are readily identified by color and duplex Doppler sonography. Initial enthusiasm for the gray scale and Doppler identification of acute rejection largely has been proved to be unfounded. Ultrasound guidance, however, clearly minimizes the risk and discomfort of definitive percutaneous renal transplant biopsy.