ECHO-DOPPLER DIAGNOSIS OF RENAL-ALLOGRAFT ARTERY-STENOSIS

For the diagnosis of allograft artery stenosis in recipients of a rena l transplant with hypertension a noninvasive investigation such as ech o-Doppler is preferable to invasive methods such as angiography. There fore we analyzed our experience with echo-Doppler diagnosis of renal a llograft artery stenosis. In 131 renal transplant recipients with hype rtension echo-Doppler examinations were performed. During the examinat ions several features indicative of stenosis were measured, and intrar enal Doppler spectra were quantitatively analyzed with a user-written program. Four patients showed signs of iliac artery stenosis. In 12 pa tients a renal allograft artery stenosis was suspected on echo-Doppler examination. In 8 of these 12 patients angiography was performed. All these showed a stenosis, 6 of which had more than >75% stenosis. In 8 patients with normal echo-Doppler findings angiography was performed because of highly suggestive clinical signs of stenosis. In 7 of these no stenosis was found and in one a 50% stenosis was found; Comparison of quantitative Doppler spectrum features from patients with (n=6) an d without severe (>75%) stenosis on angiography (n=10) showed signific ant differences in several Doppler parameters. Subsequently an analysi s of the best differentiation between these to groups on the basis of quantitative Doppler criteria was performed. In conclusion, echo-Doppl er examinations with quantitative analysis of Doppler spectra enables reliable identification of renal allograft artery stenosis.