Renal Transplant and Postsurgical Complications

— is often the best indicator of renal transplant rejection

renal biopsy

the transplanted kidney is also referred to as the

allograft

the allograft is often placed within the

right or left lower quadrant

the donor artery is typically anastomosed to the

external iliac artery and external iliac vein of the recipient

the donor ureter is attatched to the recipient

urinary bladder

the donor kidney should appear — to the normal kidney

sonographically similar

— is considered normal in the transplanted kidney

mild pelviectasis

Renal vein thrombosis. A spectral Doppler waveform from a segmental renal artery in the renal sinus demonstrating reversed diastolic flow in a patient presented with abrupt anuria 3 hours postsurgery. Thrombosis of the main renal vein was found at surgery.

the normal waveform should yeild low resistance with —

continuous diastolic flow

the resistive insitive indices should be —

0.6 to 0.8

anything over — is considered abnormal

0.9

the renal vein should demonstrate — and may be examined at the anastomosis site eith the iliac vein as well

normal continous flow away from the kidney

postrenal transplant fluid collections are commom and could be a

lymphocele, urinoma, hematoma, or abscess

these fluid collections may appear similar with sonogeaphy, with most

echogenic, complex, or anechoic

clinical signs of transplant rejection include

anuria, oliguria, elevated creatinine nad BUN, proteinuria, hypertension, and enlargement of the transplant

complications of a renal transplant include

rejection, infection, obstruction, vascular stenosis, renal artery stenosis, renal artery thrombosis, renal vein thrombosis, pseudoaneurysm, and fistulas

— is the most common vascular complication following renal transplantation

renal artery stenosis

the sonographic indication of renal artery stenosis includes — at the level of the anastomosis site

color aliasing and turbulent flow

the diagnosis of renal artery stenosis in a renal transplant includes an elevated peak systolic velocity greater than

200 to 250 cm per second

the diagnosis of renal artery stenosis in a renal transplant includes an artery to external iliac ratio greater than — and post stenostic turbulence2.0 to 3.0