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NDT Advance Access originally published online on June 27, 2008
Nephrology Dialysis Transplantation 2008 23(12):4041-4043; doi:10.1093/ndt/gfn358
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Increased peak systolic velocity in the renal artery of paediatric kidneys transplanted to adult recipients

Anne Gunther1, Aksel Foss2, Hallvard Holdaas3, Knut Brabrand1, Anders Hartmann3, Paal-Dag Line2 and Karsten Midtvedt3

1 Department of Radiology 2 Surgical Department, Section of Transplant Surgery 3 Medical Department, Section of Nephrology, Rikshospitalet University Hospital, 0027 Oslo, Norway

Correspondence and offprint requests to: Anne Gunther, Department of Radiology, Rikshospitalet University Hospital, N-0027 Oslo, Norway. Tel: +47-23070000; Fax: +47-23072610; E-mail: anne.gunther{at}rikshospitalet.no



  Abstract

Background. Paediatric kidneys transplanted to adult recipients increase in size after transplantation. It is unknown if the renal artery diameter increases concomitantly with the kidney. This study was performed to assess if peak systolic velocity (PSV) in the renal arteries of paediatric kidneys transplanted to adult recipients is comparable to PSV in the renal arteries of adult kidneys transplanted to adult recipients.

Subjects and methods. Fifteen adult patients with paediatric renal transplants were examined with ultrasound Doppler and compared with a control group of adult recipients with adult transplants. MR angiography (MRA) or intra-arterial angiography (IA) was performed in patients with elevated PSV. MRA renal diameters of the paediatric transplants were compared with adult transplants.

Results. The mean maximum PSV of the paediatric kidneys was 2.0 m/s (0.9–3.8), almost twice compared with the adult grafts transplanted to adult recipients, 1.1 m/s (0.7–1.6), P < 0.001. Seven paediatric transplants had a PSV >1.8 m/s, but only two had significant stenosis on MRA/IA. All patients had excellent blood pressure and renal function. The mean diameter of the paediatric renal arteries was 4.1 mm (3.4–6.0), whereas the mean for the adult renal arteries was 5.6 mm (4.8–6.9), P = 0.02.

Conclusion. Adult recipients of paediatric kidneys have significantly higher maximum PSV in the renal artery compared to adult recipients of adult grafts. The significantly smaller renal artery diameter might explain the high PSV. A PSV >1.8 m/s by itself does not necessarily indicate transplant renal artery stenosis in paediatric kidneys transplanted to adult recipients, but should be related to clinical findings.

Keywords: paediatric kidney; peak systolic velocity; renal transplant; transplant renal artery stenosis

Received for publication: 19. 3.08
Accepted in revised form: 2. 6.08


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