RENAL-TRANSPLANT EVALUATION WITH POWER DOPPLER SONOGRAPHY

This study was performed to determine if the marked variation we had p reviously noted in the power Doppler sonographic appearance of renal t ransplants correlated with disease. 22 renal transplants were scanned with power Doppler at 5 MHz, with biopsies being taken within 1 h in 1 7 kidneys and within 48 h in four other kidneys. Biopsy was not perfor med in one kidney with distal ureteral obstruction. Biopsy results wer e complex with many coexistent abnormalities; classification was based upon the predominant abnormality. Cortical vascularity was subjective ly evaluated as normal, decreased or markedly decreased, and graded as 0, 1 or 2, respectively, and was compared with biopsy results, serum creatinine levels and resistive index. Cortical vascularity gradings w ere: 0 (12 cases); 1 (7 cases); and 2 (3 cases). The large number of d isease categories (cellular rejection, 11 cases; vascular rejection, 5 cases; IgA nephropathy, 1 case; cyclosporin toxicity, 3 cases; obstru ction, 1 case; and lupus nephropathy, 1 case) in relation to the numbe r of vascular grades and number of kidneys precluded statistical analy sis of cortical vascularity for rejection. However, vascularity did no t appear to correlate with rejection, the three severest cases of vasc ular rejection having normal (grade 0) vascularity. There was no stati stically significant correlation of vascular grade with creatinine lev els or resistive index. In conclusion, subjective analysis of the powe r Doppler sonographic appearance of renal transplants does not appear to aid in their evaluation.