The Impact of Elevated Doppler Resistive Indices in Renal Transplant Recipients with Delayed Graft Function.
1Urology, Western University, London, ON, Canada
2Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
3Multi-Organ Transplant Program, Western University, London, ON, Canada
4Family Medicine, Schulich School of Medicine and Dentistry, London, ON, Canada
Meeting: 2017 American Transplant Congress
Abstract number: A193
Keywords: Graft function, Kidney transplantation, Post-operative complications, Radiologic assessment
Session Information
Session Name: Poster Session A: Kidney Complications I
Session Type: Poster Session
Date: Saturday, April 29, 2017
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
INTRODUCTION AND OBJECTIVES: Doppler Ultrasonography is often carried out to determine renal allograft perfusion in the early post-operative period. An elevated resistive index (RI) is associated with Acute Kidney Injury (AKI). We hypothesize that patients with delayed graft function (DGF) and elevated RIs and therefore AKI have a different functional outcome vs. patients with normal RIs.
METHODS: We retrospectively reviewed early post-op (<24hr) renal allograft doppler ultrasounds for 250 renal allograft transplants. We analyzed only patients with DGF and separated those with intra-renal RIs >0.8 vs. RIs<0.8. Outcomes were GFR at 3 months and 1 year (MDRD) as well as graft survival (GS). Patients with insufficient or incomplete follow-up data were excluded. Statistical analysis was performed using T-test and Chi-squared where appropriate. Graft survival analysis was performed with Kaplan-Meier curves.
RESULTS: In total, 77 patients had DGF, 68/77 (88%) of which were deceased donor transplants. Of DGF patients, 54 (70%) had intrarenal RIs <0.8 while 23 (30%) had RIs >0.8. Patient and donor characteristics were not statistically different between the two groups. GFR at 3 months for the high RI group was 57 ml/min/1.72m2 vs 45 ml/min/1.72m2 for the lower RI group (p=0.02). Similarly, at 1 year the GFRs were 58 and 48 ml/min/1.72m2 respectively (p=0.03). Death censored GS and Overall GS were not significantly different between these groups at a median follow-up of 6.75 years (91% vs. 94%).
CONCLUSIONS: Renal transplant patients with DGF and early post-operative RIs greater than 0.8 had superior GFR vs. patients with normal RIs. Although counterintuitive, we believe that the presence of DGF in recipients without severe ischemic reperfusion injury (normal RIs) may represent those individuals that have received kidneys with inferior intrinsic renal functional capacity.
CITATION INFORMATION: Mikhail D, Chan E, Aboalsamh G, Cruise S, Aquil S, Mohamed M, Sener A, Luke P. The Impact of Elevated Doppler Resistive Indices in Renal Transplant Recipients with Delayed Graft Function. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Mikhail D, Chan E, Aboalsamh G, Cruise S, Aquil S, Mohamed M, Sener A, Luke P. The Impact of Elevated Doppler Resistive Indices in Renal Transplant Recipients with Delayed Graft Function. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/the-impact-of-elevated-doppler-resistive-indices-in-renal-transplant-recipients-with-delayed-graft-function/. Accessed June 1, 2025.« Back to 2017 American Transplant Congress