Significance of elevated transplant renal artery velocities in the postoperative renal transplant patient.
BACKGROUND
Non-invasive imaging studies can provide visualization of allograft perfusion in the postoperative evaluation of newly transplanted renal allografts.


OBJECTIVE
The purpose of our study was to evaluate the significance of elevated renal artery velocities in the immediate postoperative period.


METHODS
Peak systolic velocities (PSVs) were obtained in the transplanted renal artery of 128 patients immediately after transplantation. Repeat allograft Doppler ultrasonography was performed on patients with elevated values.


RESULTS
Of the 128 patients, 57 (44.5%) had severely elevated Doppler velocities >400 cm/s on the initial studies. Three patients within this category had persistently elevated values of >400 cm/s, warranting angiographic visualization of the renal vessels. Stent placement within the transplanted renal artery was required in two of these patients. There was normalization of the PSV in the remaining patients.


CONCLUSIONS
Routine allograft Doppler ultrasonography in the immediate postoperative period allows for visualization of allograft perfusion. Elevated renal artery velocities in the immediate postoperative period do not necessarily represent stenosis requiring intervention. Failure of the PSV to normalize may require further intervention, and angiography continues to be the gold standard.
Department of Transplantation, North Shore Long Island Jewish Health System, Hofstra University School of Medicine, Manhasset, NY, USA. esiskind@nshs.edu
Eric
E
Siskind
Pamela
P
Lombardi
Mark
M
Blum
Richard
R
Tyrell
Manuel
M
Villa
Michael
M
Kuncewitch
Elizabeth M
EM
Olsen
Asha
A
Alex
Leandro
L
Lumermann
Madhu C
MC
Bhaskaran
Kenar D
KD
Jhaveri
Mala
M
Sachdeva
Kellie
K
Calderon
Craig
C
Greben
Daniel
D
Putterman
Eric
E
Gandras
Drew
D
Caplin
Catherine
C
D' Agostino
John
J
Pellerito
Gene
G
Coppa
Ernesto P
EP
Molmenti
D001783:Blood Flow Velocity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012077:Renal Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D018608:Ultrasonography, Doppler