DOPPLER ULTRASONOGRAPHY IN THE EARLY POSTOPERATIVE EVALUATION OF RENAL-TRANSPLANTS IN CHILDREN

The renal ultrasonography (US) scans of 23 children who had recently u ndergone kidney transplantation were reviewed; the studies included Do ppler US scanning of the arterial vessels at several levels. There wer e 43 studies for children whose postoperative course was normal; 16 st udies were obtained during episodes of acute tubular necrosis and 21 d uring episodes of acute rejection. The upper limit of normal for the r esistive index (RI) at the arcuate artery is higher (up to 0.79) for a pediatric renal transplant patient than for adults with normal kidney s, regardless of the age of the kidney donor. Therefore, elevation of the RI to 0.80 or higher or complete loss of diastolic flow always ind icates a complication of transplantation. Abnormally high RI values we re seen in patients with both acute tubular necrosis and acute rejecti on; however, the RI value as determined by US did not distinguish thes e two entities. In addition, in 7 cases of acute tubular necrosis and 12 of acute rejection the RI was normal (0.58 to 0.79).