Complications of renal transplantation: Evaluation with US and radionuclide imaging

Following renal transplantation, patients are often evaluated with ultrason ography (US) or radionuclide imaging to assess renal function and the prese nce of possible complications. Both modalities are inexpensive, noninvasive , and nonnephrotoxic. A basic understanding of the surgical techniques comm only used for renal transplantation is useful when imaging these patients i n order to recognize complications and to direct further imaging or interve ntion. The most frequent Complications of renal transplantation include per inephric fluid collections; decreased renal function; and abnormalities of the vasculature, collecting system, and renal parenchyma. Perinephric fluid collections are common following transplantation, and their clinical signi ficance depends on the type, location, size,and growth of the fluid collect ion, features that are well-evaluated with US. Causes of diminished renal f unction include acute tubular necrosis, rejection, and toxicity from medica tions. Radionuclide imaging is the most useful modality for assessing renal function. Vascular complications of transplantation include occlusion or s tenosis of the arterial or venous supply, arteriovenous fistulas, and pseud oaneurysms. Although the standard for evaluating these vascular complicatio ns is angiography, US is an excellent noninvasive method for screening. Oth er transplant complications such as abnormalities of the collecting system and renal parenchyma are well-evaluated with both radionuclide imaging and US.