Objectives:To quantitatively analyze the changes of hemodynamic characteristics in renal allograft at different stages of a rat chronic allograft nephropathy [CAN]model and the relationship between hemodynamic parameters and renal allograft fibrosis using contrast-enhanced ultrasounography [CEUS] technique

Methods:The experimental group used a CAN rat model [n = 30]. The control group used orthotopic syngeneic renal transplant model [n = 30]. After the surgery, creatinine clearance rate was regularly monitored. At 4, 12, and 24 weeks after surgery, 8 rats from each group were randomly selected for CEUS examination. Parameters related to time intensity curve [TIC], including the slope of the ascending curve [A], time to peak intensity [TTP], derived peak intensity [DPI], slope of the descending curve α, area under the curve [AUC], were determined. At the same time, chronic allograft damage index [CADI] scores was used to evaluate each group of renal allograft specimens. Immunofluorescence and Western blot were used to measure α- smooth muscle actin [alpha-SMA] and Vimentin expression in renal allograft tissue and the correlation between the expression levels and the TIC curve parameters was analyzed.

Results:Before the conventional indicator, creatinine clearance rate, for the evaluation of renal allograft function, showed significant abnormality, the renal allografts in the experimental group had already presented CAN pathological changes. At the early stage after the surgery, as compared to the TIC curve parameters of the control group, the experimental group showed prolonged TTP, increased AUC, and decreased A value and α value [P <0.05]. CADI score and the expression levels of α-SMA and vimentin proteins in renal allograft were positively correlated with the TTP and AUC, and were negatively correlated with A.

Conclusion:Compared to creatinine clearance rate, CEUS can detect CAN at earlier stages. The correlation between TIC-related parameters and the expression levels of α-SMA and vimentin proteins in renal allograft indicates that CEUS can quantitatively measure microcirculation perfusion in renal allograft, thus quantitatively assessing the degree of renal allograft fibrosis, and detecting renal allograft fibrosis induced by CAN at early stages.

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