Renal Transplant Dysfunction (Acute)
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Population Covered By The Guidance
This pathway provides guidance on the imaging of adult patients with acute renal transplant dysfunction following surgery.
Date reviewed: January 2012
Date of next review: October 2023
Published: January 2012
Quick User Guide
Move the mouse cursor over the PINK text boxes inside the flow chart to bring up a pop up box with salient points.
Clicking on the PINK text box will bring up the full text.
The relative radiation level (RRL) of each imaging investigation is displayed in the pop up box.
| SYMBOL | RRL | EFFECTIVE DOSE RANGE |
 |
None | 0 |
 |
Minimal | < 1 millisieverts |
 |
Low | 1-5 mSv |
 |
Medium | 5-10 mSv |
 |
High | >10 mSv |
Teaching Points
Teaching Points
- A Doppler ultrasound is indicated in all patients with allograft dysfunction
- Sonography is useful in diagnosing thrombosis of the renal artery or vein, urinary obstruction, urine leaks and for biopsy
- Nuclear scintigraphy can give information regarding the function of a transplanted kidney
- Renal biopsy is useful in transplanted kidneys deemed to have adequate blood flow but poor function looking for acute rejection
- Arterial obstruction demonstrated on ultrasound, can further be managed with renal angiography
References
References
References are graded from Level I to V according to the Oxford Centre for Evidence-Based Medicine, Levels of Evidence. Download the document
- O'Neill WC, Baumgarten DA. Ultrasonography in renal transplantation. Am J Kidney Dis. 2002;39(4):663-78. (Review article)
- Tublin ME, Dodd GD III. Sonography of renal transplantation. Radiol Clin North Am. 1995;33:447-59. (Review article)
- Gottlieb Th, Voci SL, Cholewinski SP, et al. Sonography: a useful tool to detect the mechanical causes of renal transplant dysfunction. J Clin Ultrasound. 1999;27:325-33. (Level II/III evidence)
- Kelcz F, Pozniak MA, Pirsch JD, et al. Pyramidal appearance and resistive index: insensitive and nonspecific sonographic indicators of renal transplant rejection. AJR Am J Roentgenol. 1990;155:531-5. (Level II evidence). View the reference
- Turetschek K, Nasel C, Wunderbaldinger P, et al. Power Doppler versus color Doppler imaging in renal allograft evaluation. J Ultrasound Med. 1996;15:517-22. (Level II evidence). View the reference
- Claudon M, Lefevre F, Hestin D, et al. Power Doppler imaging: evaluation of vascular complications after renal transplantation. AJR Am J Roentgenol. 1999;173:41-6. (Review article)
- Grenier N, Douws C, Morel D, et al. Detection of vascular complications in renal allografts with color Doppler flow imaging. Radiology. 1991;178:217-23. (Level III evidence)
- Taylor KJW, Morse SS, Rigsby CM, et al. Vascular complications in renal allografts: detection with duplex Doppler US. Radiology. 1987:162:31-8. (Level III evidence)
- Sidhu MK, Gambhir S, Jeffery RB Jr, et al. Power Doppler imaging of acute renal transplant rejection. J Clin Ultrasound. 1999;27:171-5. (Level III evidence)
- Woolfson RG, Neild GH. The true clinical significance of renography in nephro-urology. Eur J Nucl Med. 1997;24(5):557-70. (Review article)
- Cofan F, Gilabert R, Oppenheimer F et al Duplex-Doppler ultrasound and MAG-3 scintigraphy in the evaluation of acute tubular necrosis after kidney transplantation Transplant Proc. 1997;29:1376-7. (Level II evidence). View the reference
- Wilczek HE. Percutaneous needle biopsy of the renal allograft. Transplantation. 1990;50:790-7. (Level III evidence)
Further Reading
- Baxter GM. Ultrasound of renal transplantation. Clin Radiol. 2001;56:802-18. (Pictorial review)
Information for Consumers
Information for Consumers
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Consent to Procedure or Treatment Radiation Risks of X-rays and Scans |
Iodine-Containing Contrast Medium Radiation Risk of Medical Imaging During Pregnancy Radiation Risk of Medical Imaging for Adults and Children |
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