Palafox-Vázquez H

Language: Spanish
References: 17
Page: 191-197
PDF size: 699.70 Kb.

ABSTRACT

Introduction: Ultrasound is the ideal method for the initial evaluation of a transplanted kidney because it allows obtaining initial information that serves as a basal study for future evaluations and decision taking on other imaging studies.

Objective: The objective of this review is to describe the normal ultrasound findings in the immediate post-surgery period and the complications that can be detected by ultrasound in children with kidney transplantation.

Method: The initial evaluation is carried out within the first 24 hours after surgery due to the fact that the highly superficial location of the transplanted kidneys in the abdominal cavity allows optimum morphologic detail of intra-renal structures. The evaluation of the vascularity is carried out with color Doppler spectral analysis of the intra-renal arterial and venous structures, evaluating impedance or resistance of the vessel to the flow using Resistive and Pulsatility indexes. Power Doppler is used to show the vascularity of the complete vasculo-renal system from the main arteries to the arquate arteries and the fine terminal rami.
Results: Post-surgical complications of the transplantation can be classifies in three groups: infectious, are the most frequent ones and include different micro-organisms. Surgical that include the urological complications such as hydronephrosis, peri-renal fluid collections such as lymphoceles and abscesses, and vascular complications such as arterio-venous fistulae, venous thrombosis and renal artery stenosis, and finally the medical-immunologic complications which include relapse of the original disease, acute tubular necrosis, nephrotoxicity due to medications (Cyclosporine and Tacrolimus) and acute and chronic rejection which today are known as chronic dysfunction of renal transplantation.

Conclusions: Ultrasound evaluates in a satisfactory manner, peri-renal fluid collections, collecting system dilation, obstructive problems and vascular abnormalities, and can be useful in the evaluation of dysfunction secondary to medical-immunologic alterations.

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