Prediction of Renal Allograft Acute Rejection Using a Novel Non-Invasive Model Based on Acoustic Radiation Force Impulse.
Point shear wave elastography based on acoustic radiation force impulse is a novel technology used to quantify tissue stiffness by measuring shear wave speed. A total of 115 kidney transplantation recipients were consecutively enrolled in this prospective study. The patients were subdivided into two groups using 1 mo post-transplantation as the cutoff time for determining the development of acute rejection (AR). Shear wave speed was significantly higher in the AR group than in the non-AR group. We created a model called SEV, comprising shear wave speed, estimated glomerular filtration rate and kidney volume change, that could successfully discriminate patients with or without AR. The area under the receiver operating characteristic curve of SEV was 0.89, which was higher than values for other variables; it was even better in patients within 1 mo post-transplantation (0.954), but was lower than the estimated glomerular filtration rate in patients after 1 mo post-transplantation. Therefore, the SEV model may predict AR after renal transplantation with a high degree of accuracy, and it may be more useful in the early post-operative stage after renal transplantation.
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Organ Transplantation, Shanghai, China; Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Cheng
C
Yang
Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
Yunjie
Y
Jin
Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Shengdi
S
Wu
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Organ Transplantation, Shanghai, China.
Long
L
Li
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Organ Transplantation, Shanghai, China.
Mushuang
M
Hu
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Organ Transplantation, Shanghai, China.
Ming
M
Xu
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Organ Transplantation, Shanghai, China.
Ruiming
R
Rong
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Organ Transplantation, Shanghai, China.
Tongyu
T
Zhu
Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address: Wanyuanhe@126.com.
Wanyuan
W
He
D000328:Adult; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000000981:diagnostic imaging*; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging; D016030:Kidney Transplantation; D008297:Male; D011446:Prospective Studies; D015203:Reproducibility of Results; D014184:Transplantation, Homologous
Acoustic radiation force impulse; Acute rejection; Kidney transplantation; Non-invasive; Point shear wave elastography; Shear wave speed