Utility of pulsed Doppler in the diagnosis and follow-up of acute vascular graft rejection treated with OKT3 monoclonal antibody or antilymphocyte serum.
Fifteen patients with severe acute vascular graft rejection (twelve of them steroid-resistant) treated with OKT3 monoclonal antibody (8) or antilymphocyte serum (7) were sequentially studied with duplex-Doppler ultrasonography (DDUS). Measurements of intrarenal resistance were obtained by means of the resistive index (RI). During rejection episodes, the intrarenal resistance was increased in all patients (RI range: 0.89-1), with absent or reversed diastolic blood flow. Normalization of diastolic blood flow was documented prior to the decrease of serum creatinine level in all patients who recovered from a rejection episode. We conclude that DDUS is a noninvasive technique useful in the diagnosis and monitoring of acute vascular graft rejection. Prediction of graft outcome after rejection treatment could probably be made based on DDUS findings.
Gilabert
R
R
Renal Transplant Unit, Hospital Clinic i Provincial, University of Barcelona, Spain.
Campistol
J M
JM
Bru
C
C
Vilardell
J
J
Bianchi
L
L
Andreu
J
J
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D001707:Biopsy, Needle; D003404:Creatinine / Q000097:blood; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007165:Immunosuppression Therapy; D007668:Kidney / Q000000981:diagnostic imaging; D016030:Kidney Transplantation / Q000276:immunology* / Q000473:pathology; D008297:Male; D016853:Muromonab-CD3; D012079:Renal Circulation; D014463:Ultrasonography
D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum; D016853:Muromonab-CD3; D003404:Creatinine