COLOR-CODED DUPLEX-DOPPLER ULTRASONOGRAPH Y FOR DIAGNOSIS OF RENAL-VEIN THROMBOSIS IN THE EARLY PHASE FOLLOWING RENAL-TRANSPLANTATION

A total of 91 colour-coded duplex Doppler ultrasound scans were perfor med in the early phase following renal transplantation in 53 out of 10 9 patients (48.6%) between 1. 1. 1992 and 15. 3. 1993. The indications for the investigation were primary failure of functional improvement in the transplanted kidney or secondary worsening of function. In five of the 53 patients (ten scans) constant retrograde flow in the segmen tary arteries provided specific evidence of renal vein thrombosis, thi s diagnosis being confirmed histologically following nephrectomy. The Pourcelot index was raised (RI > 0.72) in all five cases. The RI was a lso raised in 35 of 53 patients; however, continuous retrograde diasto lic flow was absent. The results of renal biopsy and the clinical cour se both excluded renal vein thrombosis in these cases. The colour Dopp ler ultrasound scans were unremarkable in 13 patients. The comparison group consisted of 151 patients in the later post-transplantation phas e (> 2 months), in whom 171 colour Doppler ultrasound scans showed no signals associated with renal vein thrombosis. - In agreement with the literature, these results show that colour-coded duplex Doppler ultra sound should be regarded as the definitive diagnostic procedure for re nal vein thrombosis after transplantation, and if positive findings ar e obtained further invasive diagnostic procedures can be avoided.