Renal Transplantation complications - spectrum of findings
Number:27ESURABS0075
Type:Educational Electronic Presentation
Authors: José Eduardo Rosa, André Peixoto, Luís Vitor, João Leitão
Keywords:Kidney; Transplantation; Complications; Ultrasound; Doppler; Computer Tomography; Angiography
SECTIONS
Educational objective

To review and discuss clinical cases regarding different types of complications.

To illustrate the radiological features of these different complications, using ultrasound (US), Doppler, computer tomography (CT), and angiography images.

Fig. 1 Ultrasound showing pyelocalicial dilatation (a). CT showing a ureteral stent and lymphocele.

Topic Review

The kidney is the first and is the most frequently transplanted organ.

Renal transplant complications can be categorized, depending on the time frame in which they occur, as early, intermediate, and late.

Ultrasound  (US) with Doppler is frequently the first imaging method for transplantation evaluation in the early postoperative period because it helps to detect parenchymal abnormalities, excretory obstruction, vascular problems, perirenal collections, and guide therapeutic interventions, such as biopsy, fluid aspiration, or drainage.

Computer tomography (CT) allows the diagnosis of parenchymal, periureteral, vascular, and perirenal complications. CT scan a is the better tool to define fluid collections and their anatomic relationship to adjacent structures. CT can also accurately detect leaks from the urinary system.

Angiography has been...

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Fig. 2 - Ultrasound showing narrowed renal artery (red arrow) (a). Angiography showing a sginificant stenosis in proximal renal artery (b)


Conclusions

The kidney is the most frequently transplanted organ. Complications can occur and can be of several types.

Diagnosis is based mainly on a combination of clinical and radiological features.

The Doppler ultrasound is the first imaging method for transplantation evaluation.

For the radiologist, the knowledge of the radiological aspect of these complications is of crucial importance. Proper and timely diagnosis of these can improve the accuracy and allow better management of the disease.

Fig. 3 - Ultrasound showing an intrarenal anechoic lesion (a); Doppler ultrasound showing the same lesion with color Doppler signal and "Whirpool" sign (b); angiography showing a intrarenal pseudoaneurysm.