Contribution of power Doppler sonography to the detection of renal allograft rejection in the cynomolgus monkey.
OBJECTIVE
To evaluate whether a change in the power Doppler (PD) flow signals produced by the renal cortical interlobular vasculature of allografts in cynomolgus monkey transplant models is useful for the detection of cellular rejection and vasculopathies.


METHODS
Seventy-three monkeys with life-supporting allografts (bilateral native kidney nephrectomy) and 20 monkeys with allografts implanted with only unilateral native kidney nephrectomy were examined with ultrasound that included an examination with PD. Each graft received a PD score of 3 (normal cortical blush), 2 (reduced flow, no blush), or 1 (absence of cortical flow), and the results were compared with histology either from ultrasound-guided biopsy or at necropsy.


RESULTS
One hundred seventy-one allograft examinations (histological and PD) were compared. Histologically normal grafts were statistically more likely to have normal PD findings than were those with reduced flow or absent flow. Allografts with reduced flow had statistically more severe cellular rejection than those with normal flow. Also, vasculopathies were present in all three PD groups.


CONCLUSIONS
Reduced renal cortical flow in the cynomolgus monkey renal allograft indicates that more severe degrees of cellular rejection are present compared with allografts with normal flow. Overlap in the histological diagnoses of allografts with normal and reduced flow exists, and the finding of reduced flow with PD may be prognostically important and indicates the need for tissue sampling.
Gaschen
L
L
Novartis Pharma AG, Transplantation Research, Basel, Switzerland. alf.gaschen@dplanet.ch
Schuurman
H J
HJ
D000818:Animals; D001706:Biopsy; D006084:Graft Rejection / Q000000981:diagnostic imaging* / Q000473:pathology; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D016030:Kidney Transplantation; D008252:Macaca fascicularis; D009392:Nephrectomy; D012079:Renal Circulation; D018608:Ultrasonography, Doppler