Abstract
Of 60 renal transplant patients who underwent 134 duplex Doppler sonograms, 38 had normal frequency shift profiles and 8 showed only minimal disturbances, within normal post-transplantation limits. Fourteen patients had hypertension and showed a very abnormal profile. In 3 of the 14 the hypertension was controllable medically, and the remaining 11 underwent angiography. Duplex Doppler sonography showed gross turbulence (spectral broadening, bidirectional flow) and high frequency shift confirmed on angiography to represent 50 to 75% main renal artery stenosis in 8 of these 11, and major renal intrahilar vessel stenosis in 2. In the remaining patient, no Doppler signal was found and 95% stenosis was present. In 1 patient with intrahilar stenosis, arterial signals detected in the renal veins indicated the presence of a post-biopsy arteriovenous fistula. One patient with main renal artery stenosis also had a fistula, which was masked by a 70% stenosis. All patients with angiographically proven renal artery stenosis had a distinctive abnormality of the Doppler arterial flow pattern.
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Faenza A, Spolaore R, Poggioli G, Selleri S, Roversi R, Grozzetti G (1983) Renal artery stenosis after renal transplantation. Kidney Int [Suppl 14] 23: S-54
Sagalowsky AI, Peters PC (1984) Renovascular hypertension following renal transplantation. Urol Clin North Am 11: 491
Ingelfinger J (1980) Hypertension in children kidney transplants. In: Gruskin AB, Norman ME (eds) Pediatric nephrology. Proceedings of the Fifth International Pediatric Nephrology Symposium 1980. The Hague, Nijhoff, p 376
Broyer M, Guest G, Gagnadoux M-F, Beurton D (1987) Hypertension following renal transplantation in children. Pediatr Nephrol 1: 16
Malekzadeh M, Grushkin CM, Stanley P, Brennan LP, Stiles QR, Lieberman E (1987) Renal artery stenosis in pediatric transplant recipients. Pediatr Nephrol 1: 22
Rosenthall L, Mangel R, Lisbona R, Lacourciere Y (1974) Diagnostic applications of radiopertechnetate and radiohippurate imaging in postrenal transplant complications. Radiology 111: 347
Delmonico FL, McKusick KA, Cosimi AB, Russell PS (1977) Differentiation between renal allograft rejection and acute tubular necrosis by renal scan. AJR 128: 625
Reinitz ER, Goldman MH, Sais J, Rittgers SE, Lee MH, Mendez-Picon G, Muakkassa WF, Barnes RW (1983) Evaluation of transplant renal blood flow by Doppler sound-spectrum analysis. Arch Surg 118: 615
Arima M, Ishibashi M, Usami M, Sagawa S, Mizutani S, Sonoda T, Ichikawa S, Ihara H (1979) Analysis of arterial blood flow patterns of normal and allografted kidneys by the directional ultrasonic Doppler technique. J Urol 122: 587
Berland LL, Lawson TL, Adams MB, Melrose BL, Foley WD (1982) Evaluation of renal transplant with pulsed Doppler duplex sonography. J Ultrasound Med 1: 215
Malfi B, Ferretti G, Messina M, Salomone A, Squiccimarro G, Colla L, Rossetti M, Triolo G, Segoloni GP, Vercellone A (1986) Echo-Doppler velocimetry in the diagnosis of renal artery stenosis on transplanted kidney. Clin Nephrol 26: 181
Taylor KJW, Morse SS, Rigsby CM, Bia M, Schiff M (1987) Vascular complications in renal allografts: detection with duplex Doppler US. Radiology 162: 31
Taylor KJW, Burns PN (1984) Doppler: continuous and pulsed, superficial and deep. Syllabus RSNA Categorical Course
Smith RB, Ehrlich RM (1976) The surgical complications of renal transplantation. Urol Clin North Am 3: 621
Ricotta JJ, Schaff HV, Williams GM, Rolley RT, Whelton PK, Harrington DM (1978) Renal artery stenosis following transplantation: etiology, diagnosis, and prevention. Surgery 84: 595
LoGerfo FW, Soncrant T, Teel T, Dewey CF Jr (1979) Boundary layer separation in models of side-to-end arterial anastomoses. Arch Surg 114: 1369
Morris PJ, Yadav RVS, Kincaid-Smith P, Anderton J, Hare WSC, Johnson N, Johnson W, Marshall VC (1971) Renal artery stenosis in renal transplantation. Med J Aust 1: 1255
Braun WC (1972) The renal-allograft bruit as an indicator of good function. N Engl J Med 286: 1350
Dickerman RM, Peters PC, Hull AR, Curry TS, Atkins C, Fry WJ (1980) Surgical correction of posttransplant renovascular hypertension. Ann Surg 192: 639
Babcock DS, Slovis TL, Han BK, McEnery P, McWilliams DR (1985) Renal transplants in children: long-term follow-up using sonography. Radiology 115: 165
Greene ER, Venters MD, Avasthi PS, Conn RL, Jahnke RW (1981) Noninvasive characterization of renal artery blood flow. Kidney Int 20: 523
Dubbins PA (1986) Renal artery stenosis: duplex Doppler evaluation. Br J Radiol 59: 225
Kumar R, Wilson DD, Santa-Cruz FR (1984) Postoperative urological complications of renal transplantation. Radiographics 4: 531
Sniderman KW, Sos TA, Sprayregen S, Saddekni S, Cheigh JS, Tapia L, Tellis V, Veith FJ (1980) Percutaneous transluminal angioplasty in renal transplant arterial stenosis for relief of hypertension. Radiology 135: 23
Sos TA, Pickering TG, Saddekni S, Srur M, Case DB, Silane MF, Vaughan ED Jr, Laragh JH (1984) The current role of renal angioplasty in the treatment of renovascular hypertension. Urol Clin North Am 11: 503
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Stringer, D.A., O'Halpin, D., Daneman, A. et al. Duplex Doppler sonography for renal artery stenosis in the post-transplant pediatric patient. Pediatr Radiol 19, 187–192 (1989). https://doi.org/10.1007/BF02388654
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DOI: https://doi.org/10.1007/BF02388654