Clinical significance of the abnormal Doppler spectrum of renal blood flow in patients with long-term transplant dysfunction

Authors

  • V. V. Yakymenko SI “Zaporizhzhia Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine”,

DOI:

https://doi.org/10.14739/2310-1210.2019.2.161501

Keywords:

disease resistance, delayed graft function, kidney transplantation

Abstract

Relevance. One of the main causes of graft loss in a recipient after kidney transplantation is acute rejection.

The purpose of the work – to study the Doppler ultrasound measurements of renal transplant blood flow in patients with efficient depuration function and renal graft dysfunction in the late postoperative period following KT.

Materials and methods. As an initial step, an ultrasound examination of renal transplants was performed in 26 patients with creatinine levels within the normative values (group 1) during the period 2014–2015. The second study was based on the ultrasound examination results of the renal transplants in 26 patients with creatinine levels exceeding the standard values (group 2) during the period 2015–2016.

Results. The first group of recipients included 15 male (57.7 %) and 11 (42.3 %) female (the mean age was 31.40 ± 1.67 years). A living related kidney transplantation (LRKT) was performed in 61.54 % of patients, in 38.46 % – a cadaveric kidney transplantation (СKT). In all the patients, plasma creatinine level was within normative values or not exceeding them more than 25 %, on average, ranging from 94 to 130 µmol/L and its mean value was 114.5 ± 3.85 µmol/L.

The second group of recipients consisted of 14 (53,84%) male and 12 (46,16%) female (the mean age was 38.99 ± 2.32 years). LRKT was performed in 6 patients, and СKT in 20 patients. In all the patients plasma creatinine level was above the normal range, on average, ranging from 155 to 629 µmol/L and its mean value was 259.46 ± 35,33 µmol/L.

Conclusions. The obtained data reliably indicate that if TAMX of interlobar arteries less than 15 cm/s, the probability to reveal the clinical signs of renal allograft dysfunction is more than 90 %, regardless of the renal segment evaluation in recipients in the long-term period after organ transplantation.

References

Delmonico, F. L., Gunderson, S., Iyer, K. R., Danovitch, G. M., Pruett, T. L., Reyes, J. D., & Ascher, N. L. (2018). Deceased Donor Organ Transplantation Performed in the United States for Non-Citizens and Non-Residents. Transplantation, 102(7), 1124–1131. doi: 10.1097/TP.0000000000002086

Molina-Ortega, A., Martín-Gandul, C., Mena-Romo, J. D., Rodríguez-Hernández, M. J., Suñer, M., Bernal, C., et al. (2018). Impact of Pretransplant CMV-Specific T-cell Immune Response in the Control of CMV Infection after Solid Organ Transplantation: a prospective cohort study. ClinMicrobiol Infect, pii: S1198-743X(18)30657-8. doi: 10.1016/j.cmi.2018.09.019

Nishimura, H., Yamada, Y., Hisano, S., Mitsuke, A., Tatarano, S., Gotanda, T., et al. (2018). Long-term desensitization for ABO-incompatible living related kidney transplantation recipients with high refractory and rebound anti-blood type antibody: case report. BMC Nephrol, 19(1), 254. doi: 10.1186/s12882-018-1053-8

Ravindranath, M. H., Jucaud, V., Banuelos, N., Everly, M. J., Cai, J., Nguyen, A., & Terasaki, P. I. (2017). Nature and Clonality of the Fluoresceinated Secondary Antibody in Luminex Multiplex Bead Assays Are Critical Factors for Reliable Monitoring of Serum HLA Antibody Levels in Patients for Donor Organ Selection, Desensitization Therapy, and Assessment of the Risk for Graft Loss. J Immunol, 198(11), 4524–4538. doi: 10.4049/jimmunol.1700050

Solid, C. A., Peter, S. A., Natwick, T., Guo, H., Collins, A. J., & Arduino, J. M. (2017). Impact of Renal Disease on Patients with Hepatitis C: A Retrospective Analysis of Disease Burden, Clinical Outcomes, and Health Care Utilization and Cost. Nephron, 136(2), 54–61. doi: 10.1159/000454684

Lees, J. S., McQuarrie, E. P., & Mackinnon, B. (2018). Renal biopsy: it is time for pragmatism and consensus. Clin Kidney J, 11(5), 605–609. doi: 10.1093/ckj/sfy075

Incerti, D., Summers, N., Ton, T. G. N., Boscoe, A., Chandraker, A., & Stevens, W. (2018). The Lifetime Health Burden of Delayed Graft Function in Kidney Transplant Recipients in the United States. MDM Policy Pract, 3(1), 2381. doi: 10.1177/2381468318781811

Apel, H., Putz, J., Fornara, P., Friedersdorff, F., Dreikorn, K., & Stöckle, M. (2017). Report of the 24th annual conference of the Working Group Kidney Transplantation of the German Society of Urology in Erlangen. Urologe A, 56(9), 1182–1184. doi: 10.1007/s00120-017-0452-y

Lim, E., Kim, Y., Jeong, J. C., Park, I., Kim, H., Lee, S. H., et al. (2017). Clinical analysis of single filtration plasmapheresis using continuous renal replacement therapy machines in kidney transplantation. Kidney Res ClinPract, 36(2), 192–199. doi: 10.23876/j.krcp.2017.36.2.192

Kezić, A., Stajic, N., & Thaiss, F. (2017). Innate Immune Response in Kidney Ischemia/Reperfusion Injury: Potential Target for Therapy. J Immunol Res, 2017, 6305439. doi: 10.1155/2017/6305439

Downloads

How to Cite

1.
Yakymenko VV. Clinical significance of the abnormal Doppler spectrum of renal blood flow in patients with long-term transplant dysfunction. Zaporozhye Medical Journal [Internet]. 2019Apr.2 [cited 2024Nov.13];(2). Available from: http://zmj.zsmu.edu.ua/article/view/161501

Issue

Section

Original research