Quevedo-Pardo RF, Mejía-Duarte N, Guerrero-Avendaño G

Language: Spanish
References: 12
Page: 208-215
PDF size: 306.19 Kb.

ABSTRACT

Introduction. The number of institutions that perform transplants is growing worldwide and kidney transplants are among the most frequent, especially in our institution: Hospital General de Mexico. For this reason we have decided to document the most common postoperative findings, by Doppler ultrasound (DU) and with up to two years’ follow-up, in patients subjected to kidney transplant and correlate the findings with the clinical evolution reported in their clinical records.
Material and methods. A retrospective longitudinal study was conducted in patients who underwent kidney transplants secondary to terminal kidney failure, with organs from living or cadaver donors, operated with the same surgical technique for both types of donor, in the period between October 22, 2010, and July 2, 2013. Of 131 transplant patients 77 who had graft control studies in our institution’s image filing system were included in our investigation. The data obtained were classified in four groups of complications.
Results. Of the 77 patients included in our study, 31 (40.3%) presented no abnormal finding in the control DUs taken; 46 patients (59.7%) did present some kind of complication. Of the latter, we found that, in the follow-up period, 39 (50.6 %) presented a single finding, 5 (6.5%) presented two different echographic findings, and two individuals (2.6%) presented three echographic findings. A total of 57 complications classified in four different possible groups were counted.
Discussion. Despite the lack of an established follow-up protocol and the fact that the main indication from Doppler ultrasound graft control studies was due to a complication in its evolution; we found that the evolution of patients subjected to kidney transplant secondary to chronic kidney failure in our hospital presents an incidence of complications similar to that documented in the global literature and the expected periods of appearance. The most common complications in our institution were perirenal collections followed by graft dysfunction and then, farther behind, collector system complications, and finally vascular complications.
Conclusions. Echography can characterize many potential complications of kidney transplant and is the image diagnosis mode most widely used to monitor kidney transplant in the postoperative period and in long-term controls. Ultrasound guarantees an early, precise diagnosis and helps ensure a successful outcome in transplants.

REFERENCES

1. Levey Andrew S, Eckardt Kai-Uwe, Tsukamoto Yusuke, et al. Kidney Disease: Improving Global Outcomes. Kidney International 2005;1:135–146.

2. Mathur VS, Bretan PN Jr, Tomlanovich SJ. Management of end-stage renal disease: transplantation or dialysis? Curr Opin Urol 1994;4:95–99.

3. Brown Elizabeth D, Chen Michel Y. M, Wolfman Neil T, Ott David J, Watson Jr Nat E. Complications of renal transplantation evaluations a whith us and radionuclide imaging. RadioGrapichs 2000;20:607–622.

4. Park Sung Bin, Kon Kim Jeong, Cho Kyoung-Sik. Complications of renal transplantation. J Ultrasound Med 2007;26:615–633.

5. Akbar Syed A, Jafri S. Zafar H, Amendola Marco A, Madrazo Beatrice L, Salem Riad, Bis Kostaki G. Complications of renal transplantation. RadioGraphics 2005;25:1335–135.

6. Rifkin Matthew d, Needleman Laurence, Pasto Matthew E, et al. Evaluation of renal transplant rejection by duplex Doppler examination: value Doppler examination. ARJ 1987;148:759-762.

7. Baxter GM. Ultrasound of renal transplantation. Clin Radiol 2001;56:802–818.

8. Letourneau Janis G,. Day Deborah L, Ascher Nancy L, Castaneda- Zuniga Wilfrido R. Imaging of renal transplant. AJR 1988;150:833-838.

9. Yamamoto Akira, Zhang Jeff L, Rusinek Henry, et al. Quantitative Evaluation of Acute Renal Transplant Dysfunction with Low-Dose Threedimensional MR Renography. Radiology 2011;260(3):781-789.

10. Tublin ME, Dodd GD III. Sonography of renal transplantation. Radiol Clin North Am 1995;33:447–459.

11. Pozniak MA, Dodd GD III, Kelcz F. Ultrasonographic evaluation of renal transplantation. Radiol Clin North Am 1992;30:1053–1066.

12. Garcia-Covarrubias L, Martinez A, Morales-Buenrostro L.E, et al. Parameters of Doppler Ultrasound at Five Days Posttransplantation as Predictors of Histology and Renal Function at One Year. Transplantation Proceedings 2010;42:26.