Ultrasound in Renal Transplantation

Abstract

Because of important differences in prognosis and treatment, prompt and accurate diagnosis of fever, decreasing function and pain and tenderness around a renal allograft is crucial for differentiation between acute rejection and other post-operative conditions which may give a similar picture. Ultrasound examinations within 24 h have been performed on all transplant recipients [human] exhibiting symptoms compatible with an episode of acute rejection between Sept. 1973 and June 1976 at the Peter Bent Brigham Hospital [Boston, Massachusetts, USA]. The patients were separated into 4 groups dependent upon diagnosis by ultrasound; Group I (73 patients), allograft enlargement consistent with acute rejection; Group II (14 patients), dilitation of the collecting system; Group III (14 patients), perinephric fluid collections; Group IV (6 patients), miscellaneous conditions. The accuracy of the ultrasound technique was compared within each group to the results from i.v. pyelography, retrograde pyelography, serial renograms, kidney biopsy and/or surgical exploration. This convenient, non-invasive and reproducible method has been extremely effective in the differential diagnosis of rejection in clinical transplantation.