[The value of pulsed Doppler for the follow-up of the transplanted kidney in the first 3 months of transplantation].
This prospective study was conducted in 34 consecutive renal transplant patients. Pulsed doppler was used to evaluate the peripheral resistance (PR) in the transplant vessels. Under normal conditions, the PR of the graft is low, resulting in a continuous diastolic blood flow. The intensity of this blood flow was evaluated by means of a resistance index (RI), Pourcelot's index, calculated as follows: RI = systolic peak - end-diastolic peak/systolic peak This study demonstrated values for RI of 0.71 +/- 0.087 in 14 totally asymptomatic patients. In 10 cases of acute rejection, the RI increased to 0.91 +/- 0.12. The 7 patients with acute tubular necrosis had an RI equal to 1. In patients with cytomegalovirus infection of suffering from cyclosporin overdose, the RI was not modified in relation to asymptomatic subjects. This study demonstrates the existence of a rise in the PR in cases of acute rejection and acute tubular necrosis with a sensitivity of 90% and 100% respectively for these two diagnoses. However, this method cannot be used to distinguish between acute rejection and acute tubular necrosis.
Attal
M
M
Service de Radiologie, Hôpital de la Pitié, Paris.
Bitker
M O
MO
Bousquet
J C
JC
Luciani
J
J
Maidenberg
M
M
Bellin
F
F
Curet
P
P
Chatelain
C
C
Grellet
J
J
D003524:Cyclosporins / Q000633:toxicity; D003586:Cytomegalovirus Infections / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000098:blood supply* / Q000187:drug effects; D016030:Kidney Transplantation / Q000502:physiology*; D007683:Kidney Tubular Necrosis, Acute / Q000503:physiopathology; D008297:Male; D012039:Regional Blood Flow / Q000502:physiology; D012077:Renal Artery / Q000502:physiology; D014463:Ultrasonography; D014655:Vascular Resistance / Q000502:physiology*
D003524:Cyclosporins
Intérêt du Doppler pulsé pour la surveillance du rein transplanté dans les trois premiers mois de la greffe.