2085758 Renal Transplant- Early Post-Surgical Ceus in The Detection of Rejection and in Predicting Subsequent Kidney Function

Abstract

Kidney transplantation is the most common transplant surgery in the world and despite great improvements in surgical technique and post-operative care; the complication rate is still fairly high (up to 30%). Early studies have suggested there might be a correlation between contrast ultrasound perfusion patterns in a kidney transplant and its subsequent function and complications such as rejection and ATN. 105 kidney transplants had a CEUS at day 1 following surgery. Each kidney was scanned for 60 seconds and a region of interest was placed on the artery, cortex and medulla and a perfusion graph plotted. The haemodynamic factors were calculated from these graphs and documented along side non-perfusion factors such as donor age, recipient BMI, etc.. Each patient was followed up for serum creatinine and eGFR for 3 months to demonstrate renal function. Any episodes of rejection and/or ATN were also documented. The haemodynamic and other variables showed good correlation using linear regressions with subsequent function particularly with creatinine at 2 weeks (R=0.765, p<0.0005) and 3 months following surgery (R= 0.633, p<0.0005). Area under the curve in the cortical ROI and donor age contributing most significantly to these correlations. The difference in cortex and medulla rise time also demonstrated significant differences in groups with/without early rejection (t=2.586, p<0.0005). However, this was no greater than the differences seen in the RI between these groups (t= 3.611, p<0.0005). No significant differences were seen in the with/without ATN groups. CEUS perfusion studies in early kidney transplants could be used to inform expectation of function within the first 3 months. There is some indication that it may useful in detecting rejection but in this study does not out-perform the standard technique of measuring RI.