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VASCULAR 4 > 1.4 Renal Transplants > Flashcards

1.4 Renal Transplants Flashcards

1
Q

Renal transplants are standard treatment for?

A

Chronic renal failure

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2
Q

What is the term for kidney transplanted from one human to another?

A

Renal Allograft

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3
Q

Kidney can be harvested from (2)?

A
  1. living doner

2. brain dead donor

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4
Q

What is another name for a brain dead donor?

A

Cadaveric donor

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5
Q

Where are the transplanted kidneys placed?

A

Iliac Fossa
between the peritoneum and the iliacus muscle
(more superficial)

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6
Q

What happens to the native kidneys?

A

left in place

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7
Q

In long term Dialysis pateints the native kidneys are prone to?

A

Cysts and neoplasms

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8
Q

Allograft ureter is passed ___________ thru the muscular layer of the bladder

A

obliquely

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9
Q

What does the Allograft ureter form?

A

Non-refluxing UV junction

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10
Q

How is the allograft vein is anastomosed?

A

End to side with the iliac vein

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11
Q

Allograft artery has One or Many ways of being attached?

A

Many

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12
Q

Do transplanted kidneys look similar or different to native?

A

Similar

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13
Q

Post transplant kidneys may appear more___________ due to lack of attenuating structures over them

A

echogenic

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14
Q

Allograft usually _________ over period of months following transplant

A

Enlarges (up to 30%)

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15
Q

What could the enlargement of the kidney be mistaken for?

A

Rejection

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16
Q

Slight dilatation of the collecting system is called ____ and is common in allograft

A

Hydronephrosis

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17
Q

When should a baseline study be done after operation

A

Within 72 hours

18
Q

List the Complications of Renal transplant (7)

A
  1. Rejection
  2. Acute Tubular necrosis
  3. Av Fistula
  4. Arterial Stenosis
  5. Perigraft Fluid
  6. Pseudoaneurysm
  7. Venous/Arterial Thrombosis
19
Q

Should rejection be diagnosed Sonographically?

A

No

not unless several rejection related abnormalities are present

20
Q

What will rejection waveforms look like?

A

High resistance

with minimal to absent diastolic flow

21
Q

What will the rejection RI be ?

A

> /= 0.7 is abnormal

22
Q

Acute Tubular necrosis is a post surgical response resulting from?

A

Ischemia

23
Q

Acute Tubular Necrosis does not usually alter Doppler BUT an increase in ______ could be seen

A

PI (pulsatility index)

24
Q

What are examples of perigraft fluid (4)

A
  1. Seromas
  2. Hematomas
  3. Abscessess
  4. Urinomas
25
Q

What does color doppler help detect in these collections?

A

Active bleeding

26
Q

AV fistula often occurs from?

A

Biopsy Trauma

27
Q

AV fistula are commonly symptomatic or asymptomatic?

A

asymptomatic

28
Q

AV fistula may be associated with?

A

Sustained hypertension

29
Q

AV fistula appears as a __________spot in the renal ______ due to its ________ flow.

A

Bright; parenchyma; disturbed

30
Q

High velocity flow in the ______ artery with a visible Color Doppler_____

A

Feeder artery; bruit

31
Q

How common are venous/arterial thrombosis in transplants (%)?

A

< 1%

32
Q

How soon do venous/arterial thrombosis happen if they do?

A

immediately post operation

33
Q

What do venous/arterial thrombosis look like on 2D (3)?

A
  1. enlarged kidney
  2. distended renal vein
  3. absent flow signals in renal vein/artery
34
Q

What is the most common vascular complication occurring in transplanted patients?

A

Arterial stenosis

35
Q

What percentage of Arterial stenosis occurs in transplanted patients?

A

10 %

36
Q

Where does the Arterial stenosis usually occur ?

A

at the anastomosis

37
Q

What is the Arterial stenosis usually due to?

A

Surgical issues

38
Q

Do older or newer transplants have long segment stenosis?

A

Older

39
Q

What is the long segment stenosis due to? (2)

A
  1. Scarring
    or
  2. Hyperplasia
40
Q

Doppler shows ______ velocity in the stenotic segment post stenotic turbulence and distal _____ with severe stenosis

A

Increased; dampening

VASCULAR 4 (8 decks)

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