Sonography: a useful tool to detect the mechanical causes of renal transplant dysfunction.
OBJECTIVE
The purpose of this study was to evaluate the utility of sonography in distinguishing between mechanical and nonmechanical causes for renal transplant dysfunction.


METHODS
We reviewed all ultrasound examination reports (n = 286) for 63 consecutive patients who received 64 renal transplants. We assessed the sensitivity and specificity of different degrees of hydronephrosis (mild, moderate, or severe) in detecting urinary tract obstruction; different volumes of new or increasing peritransplant fluid in detecting urine leaks; different total volumes of peritransplant fluid in predicting significant compression of the transplant; and Doppler vascular criteria for predicting arterial and venous occlusion.


RESULTS
All mechanical complications were detected (100% sensitivity) with specificities of 91.9% for ureteral obstruction (criterion, moderate hydronephrosis), 83.4% for urine leaks (criterion, any new fluid or any increase), 91.4% for fluid collections that compressed the transplant (criterion, > 100 ml), and 100% for vascular occlusion (criteria, no flow for arterial occlusion; no venous flow and reversal of arterial flow during diastole for venous occlusion).


CONCLUSIONS
Sonography is very useful in distinguishing between mechanical and nonmechanical causes for renal transplant dysfunction. It has high sensitivity and acceptable specificity in this setting.
Department of Radiology, University of Rochester Medical Center, New York 14642, USA.
R H
RH
Gottlieb
S L
SL
Voci
S P
SP
Cholewinski
D F
DF
Hartley
D J
DJ
Rubens
M S
MS
Orloff
O L
OL
Bronsther
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006084:Graft Rejection / Q000000981:diagnostic imaging*; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012039:Regional Blood Flow; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods / Q000592:standards*; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging*