ROLE OF IMAGING IN RENAL TRANSPLANT COMPLICATIONS � A HOSPITAL BASED STUDY

Abstract

Background: Thirty five thousands patients receive renal transplants every year world wide. This study was conducted to determine and evaluate the diagnostic role and accuracy of Ultrasonography including Doppler analysis and Radionuclide Scanning in patients with renal transplant complications. Subjects and Methods: It was an observational study. Cases were collected from AFIU, MH and Jinnah Memorial Hospital Rawalpindi. Ultrasound and Doppler analyses were done in the Radiology Department of CMH Rawalpindi. Renal isotope scans were performed at NMC Rawalpindi. A total number of 52 patients were studied. Male female ratio was 42 to 10 (80.8% to 19.2%). The post-transplant duration was 02 days to 06 years. Result: The most frequent complications were peri-transplant fluid collection (27%), followed by rejection of transplant (25%) and cyclosporine nephrotoxicity (11.54%). Other complications which were also observed were Acute Tubular Necrosis (7.69%) and hydronephrosis (15.4%).  Conclusion: Ultrasound is excellent modality to evaluate location, volume and change in volume of Perinephric fluid collection. Radionuclide imaging detects altered or diminished renal function due to acute tubular necrosis, rejection of transplant and toxicity from medications. Radionuclide imaging is most useful modality for assessing renal function. Standard for evaluating vascular complications is angiography, however duplex Doppler ultrasound is an excellent non invasive method for screening. Other transplant complications like abnormalities of collecting system and renal parenchyma are well evaluated by both ultrasound and radionuclide imaging.