PROTOCOL DOPPLER COLOR-FLOW IMAGING IMMEDIATELY AFTER KIDNEY-TRANSPLANTATION

Doppler color flow imaging has been used to identify obstruction, reje ction, and nonfunctioning renal allografts. When done in the immediate posttransplant period on poorly functioning kidneys, it allows early and accurate detection of surgically correctable changes such as arter ial or venous thrombosis or early obstruction by blood, urine, or lymp h. Further, it determines changes in intrarenal flow patterns that may indicate early transplant dysfunction, such as acute tubular necrosis and/or acute rejection as well as obstruction. Additionally, baseline values can be obtained in uncomplicated cases for serial follow-up. B etween July 1980 and February 1991, 20 transplant patients had Doppler color flow imaging in the immediate posttransplant period. The kidney contour, perirenal collections, vessel flow patterns, and resistive i ndexes were assessed. In two patients, immediate surgical intervention salvaged the allograft. In several other patients with primary nonfun ctioning kidneys, the study distinguished between acute tubular necros is and obstruction due to external compression. We concluded that prot ocol Doppler color flow imaging is valuable in the immediate posttrans plant period for determining surgically correctable complications.