The Natural History of Kidney Graft Cortical Microcirculation Determined by Real-Time Contrast-Enhanced Sonography (RT-CES)
1Nephrology, Hospital Univeritario La Paz, Madrid, Spain
2Biostatistics, Hospital Univeritario La Paz, Madrid, Spain.
Meeting: 2015 American Transplant Congress
Abstract number: B95
Keywords: Image analysis, Kidney transplantation, Ultrasonography
Session Information
Session Name: Poster Session B: Kidney and Donor Evaluation/Utilization
Session Type: Poster Session
Date: Sunday, May 3, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Decreasing kidney graft cortical microcirculation has been related to poor prognosis in kidney transplantation. Cortical capillary blood flow (CCBF) can be measured by real-time contrast-enhanced sonography (RT-CES)
Our aim was to describe the natural history of CCBF over time under diverse conditions of kidney transplantation, to explore the influence of donor conditions and recipient events, and to determine the capacity of CCBF for predicting renal function in medium term.
Methods: We evaluated all patients who underwent kidney transplantation in our unit from 2009 to 2010 by RT-CES. All available patients at each moment were studied after 48 h, 5-7 days, and 1, 3 and 12 months after transplantation. Graft cortical capillary blood flow was measured. Clinical variables were analyzed.Statistical analysis: mean ± SD, medians and quartiles. Univariate and multivariate analysis using mixed regression models based on sequential measurements for each patient over time.
Results: 89 kidney transplantations were performed in our institution. Ten patients were excluded from the longitudinal study due to premature graft loss (during the first 15 days)
The CCBF values varied significantly over the study periods and were significantly lower at 48 h and day 7 than at months 1 and 3. The mean CCBF value at month 12 was 36.7± 22.7 dB/s, with minimum and maximum values on day 7 and at months 1 and 3, respectively.
Living donors showed higher mean CCBF levels than cadaver donors. These significant differences persisted at month 12 (54.5 ± 28.2 vs 33.7 ± 30 dB/sec, living vs cadaver donor, respectively, p=0.004) despite similar serum creatinine levels.
Brain-dead donor age and CCBF levels showed an inverse relationship (r: -0.62, p<0.001)
A sole rejection episode was associated with lower overall CCBF values over the first year (p<0.05).
CCBF defined better than level of serum creatinine the graft function status at medium-term (3 years)
Conclusions: RT-CES is a tool that can accurately quantify and iteratively measure cortical graft microcirculation in kidney recipients. We have described the natural history of cortical capillary blood flow under regular clinical conditions and shown how it could become a reference for clinicians who use contrast-enhanced sonography in this field. More studies are warranted to confirm these results.
To cite this abstract in AMA style:
Jiménez C, López M, Ros A, Aguilar A, Menendez D, Rivas B, Santana M, Madero R, Selgas R. The Natural History of Kidney Graft Cortical Microcirculation Determined by Real-Time Contrast-Enhanced Sonography (RT-CES) [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/the-natural-history-of-kidney-graft-cortical-microcirculation-determined-by-real-time-contrast-enhanced-sonography-rt-ces/. Accessed May 9, 2025.« Back to 2015 American Transplant Congress