Abstract
Introduction:The role of single Doppler-derived renal resistive index (RI) in renal allograft management is still a controversial issue, however detection of changes in serial duplex scanning has been reported as more valuable. This study aimed to test the hypothesis that early change in RI following transplantation may be related to factors associated with delayed graft function (DGF).Material and methods:113 patients were included, in whom two RI measurements were performed within 30 days post-transplant. According to an RI change (equal to or more than 10%) in the second measurement, patients were assigned to decrease (Group I), no change (Group II), or increase (Group III) group.Results:30 subjects had a decrease, 55 had no change, and 28 had an increase in the second RI measurement. The donors were younger in Group III in comparison to Group II. In comparison to Group I, Group III had a higher frequency of deceased donor, DGF, and presence of tubular necrosis and tubular vacuolization in peri-implantation biopsies.Conclusion:the increase of RI during the first weeks of the postoperative period seems to be associated with DGF and with tubular necrosis / tubular vacuolization in peri-implantation biopsies, likely related to ischemia reperfusion injury.
Highlights
The role of single Dopplerderived renal resistive index (RI) in renal allograft management is still a controversial issue, detection of changes in serial duplex scanning has been reported as more valuable
Three cases were excluded: one because of RI first measurement was later than one week, another due to need for reoperation, and the final one following a clinical and histological diagnosis of acute rejection
The first RI measurement was performed in the 3.88 ± 1.56 and the second in the 16.58 ± 5.28 postoperative day
Summary
The role of single Dopplerderived renal resistive index (RI) in renal allograft management is still a controversial issue, detection of changes in serial duplex scanning has been reported as more valuable. In comparison to Group I, Group III had a higher frequency of deceased donor, DGF, and presence of tubular necrosis and tubular vacuolization in peri-implantation biopsies. Detection of changes in serial duplex scanning has been reported as more valuable for diagnosing allograft dysfunction[5]. This issue is still a matter of debate[6,7,8], rendering the interpretation of RI difficult in transplantation practice
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