Renal Transplants Flashcards
What is the standard treatment of chronic renal failure?
Renal allograft
What is an allograft?
An organ harvested from a living, related donor or a cadaveric donor
Where is the transplant kidney placed?
Iliac fossa
What are native kidneys prone to?
Cysts and neoplasms
Where is the allograft ureter located?
More superior in the bladder
What does the allograft ureter form?
Non-refluxing UV junction
How is the allograft vein attached to the iliac vein?
End to side
What vein is the allograft vein attached to?
Iliac vein
How is the allograft artery attached?
Various
What sonographic appearance does the allograft have compared to the native kidney/
More echogenic cortex, larger (up to 30% enlarged) over months following transplant, pelvic fullness
When should a baseline study of the allograft be done?
72 hrs post op
What are some complications of renal transplants?
Rejection, acute tubular necrosis, perigraft fluid, pseuodaneurysm, AV fistula, venous/arterial thrombosis, arterial stenosis
What is the waveform like of a rejecting kidney?
High resistance
What is the RI like of a rejecting kidney?
> /= 0.7
What may mimic rejection?
Cyclosporine toxicity
What is acute tubular necrosis?
Post surgical response from ischemia
What does the Doppler look like in ATN?
Usually not altered, possible increase in PI
What are some examples of perigraft fluid?
Serous, hematoma, abscess, or urinoma
Where is perigraft fluid seen?
Post op
What can CDI help determine with perigraft fluid?
If there’s active bleeding
Where do most pseudoaneurysms occur?
Renal parenchyma (others can occur at arterial anastomosis site)
Why do pseudoaneurysms occur?
Arterial laceration from biopsy
What is the arterial anastomosis site?
Main artery is connected to allograft artery
What does an AV fistula occur from?
Biopsy
