Abstract
Ultrasound examination is advised for early post-kidney transplant assessment. Grayscale median (GSM) quantification is novel in the kidney transplant field, with no systematic assessment previously reported. In this prospective cohort study, we measured the post-operative GSM in a large cohort of adult kidney transplant recipients (KTR) who consecutively underwent Doppler ultrasound directly after transplantation (within 24 h), compared it with GSM in nontransplanted patients, and investigated its association with baseline and follow-up characteristics. B-mode images were used to calculate the GSM in KTR and compared with GSM data in nontransplanted patients, as simulated from summary statistics of the literature using a Mersenne twister algorithm. The association of GSM with baseline and 1-year follow-up characteristics were studied by means of linear regression analyses. In 282 KTR (54 ± 15 years old, 60% male), the median (IQR) GSM was 55 (45–69), ranging from 22 to 124 (coefficient of variation = 7.4%), without differences by type of donation (p = 0.28). GSM in KTR was significantly higher than in nontransplanted patients (p < 0.001), and associated with systolic blood pressure, history of cardiovascular disease, and donor age (std. β = 0.12, −0.20, and 0.13, respectively; p < 0.05 for all). Higher early post-kidney transplant GSM was not associated with 1-year post-kidney transplant function parameters (e.g., measured and estimated glomerular filtration rate). The data provided in this study could be used as first step for further research on the application of early postoperative ultrasound in KTR.
Highlights
Introduction of the Grayscale Median forUltrasound TissueCharacterization of the Transplanted KidneyCamilo G
We found that early post-operative Grayscale median (GSM) of kidney transplant recipients was qualitatively and quantitatively higher than in kidneys of nontransplanted patients previously reported in the literature [13]
We found that, in kidney transplant recipients, GSM values were positively associated with donor age and kidney transplant recipient blood pressure and inversely with kidney transplant recipient history of cardiovascular disease
Summary
Introduction of the Grayscale Median forUltrasound TissueCharacterization of the Transplanted KidneyCamilo G. Ultrasound Tissue Characterization of the Transplanted Kidney. Kidney transplantation is the optimal treatment strategy for patients with end-stage renal disease (ESRD), as it improves both patient survival and quality of life [1]. Post-transplant ultrasound is primarily used for the exclusion of vascular (i.e., transplant renal artery stenosis and arteriovenous fistula) and urological (i.e., ureteral obstruction and urinoma) complications [4]. Besides this visual grayscale ultrasound examination, the most commonly used ultrasound technique after transplantation is measurement of the intrarenal resistance index (RI), by color and spectral Doppler [4,5]. Associations with post-transplant outcomes, such as transplant and patient survival, were described [8,9]
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