[Doppler color ultrasonography in the assessment of double kidney transplantation].
OBJECTIVE
In our Transplant Centre, in the last three years, twelve patients with chronic kidney disease underwent a "double kidney" transplant according to Masson technique. Our purpose is the evaluation of ultrasonography and echo-colorDoppler ultrasound in the diagnosis of possible clinical and surgical complications of "double kidney" transplant.


METHODS
The "double kidney" transplant inclusion criteria are the following: donor age > 70 yrs; glomerulosclerosis > 20%; histological score (according to Kandinsky) > 4 and < 6. In our centre, from January 1998 to December 2001, we made 68 kidney transplantations from marginal donors, 12 of them were "double transplant". Mean donor age was 74.3 +/- 5.3 (70-82). Renal function was determined by detection of serum creatinine; every single patient underwent to ultrasonography evaluation of grafts during follow-up.


RESULTS
Mean follow-up is 10 +/- 4.6 months (6-18); mean value of donor's serum creatinine 1.5 +/- 0.6 mg/dl. Delayed Graft Function (DGF) rate was 50%; no case of Primary Non Function (PNF) and Acute Rejection was found. Patients with DGF (group A) had a Resistance Index (IR) > 0.80 (mean 0.82); patients without DGF (group B) had an IR < 0.80 (mean 0.68 and 0.65) (p < 0.05). All patients underwent an eco colorDoppler evaluation after 3 and 6 months; in both groups (A and B) IR was, respectively, 0.75 and 0.71. Surgical adverse events were 41.6% (5/12): 3 urinary obstructions; 1 thrombosis of renal vein; 1 pelvic lymphocele. In all these patients the first diagnostic step was ultrasonography. Ultrasonography, in "double transplant" as in single one, have a very important role in post-transplant evaluation of DGF and surgical complications.
Selvaggio
Oscar
O
Cattedra di Urologia, Policlinico, Piazza G. Cesare, 11-70124 Bari.
Martino
Pasquale
P
Palazzo
Silvano
S
Battaglia
Michele
M
Ditonno
Pasquale
P
Di Lorenzo
Vito
V
Selvaggi
Francesco Paolo
FP
D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000000981:diagnostic imaging* / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color