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NDT Advance Access published online on February 2, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp016
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Rapid adaptation of the intrarenal resistance index after living donor kidney transplantation

Markus Aschwanden1, Michael Mayr2, Stephan Imfeld1, Jürg Steiger2, Kurt A. Jaeger1 and Christoph Thalhammer1

1 Department of Angiology, University Hospital Basel 2 Clinic for Transplant Immunology and Nephrology, University Hospital Basel, Basel, Switzerland

Correspondence and offprint requests to: Christoph Thalhammer, Department of Angiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland. Tel: +41-61-265-51-57; Fax: +41-61-265-53-56; E-mail: christoph.thalhammer{at}usz.ch



  Abstract

Background. Limited data exist concerning changes of renal perfusion directly after kidney transplantation. Colour-coded duplex sonography is the accepted method to assess kidney perfusion after transplantation. A widely used, although unspecific, Doppler parameter is the intrarenal resistance index (RI). The aim of this study was to clarify the influence of different patient- and procedure-related factors on RI before and immediately after living kidney transplantation.

Methods. In a prospective study, 80 living kidney transplantation donor–recipient pairs were included. RI was measured in the donor 1 to 3 days before nephrectomy and in the recipient during the first hour after transplantation to examine the influence of age, heart rate, duration of cold and warm ischaemia time and immunosuppressive medications.

Results. Mean RI did not differ between donors and recipients. RI correlated with age, both in donors (r = 0.58, P < 0.001) and recipients (r = 0.39, P < 0.001). In recipients, 10 or more years younger than their donors (n = 24), an average decrease of 0.05 in RI compared to the donors’ value was observed (P = 0.01). Heart rate, cold and warm ischaemia time and immunosuppressive medications had no influence on the recipient RI. In patients with delayed graft function, a significant increase in RI within 14 days was observed. However, the initial RI was not predictive of graft function.

Conclusions. The transplanted kidney seems to be able to adjust its RI within a short time despite several potential harmful factors that can occur during the transplantation.

Keywords: Doppler sonography; living donor kidney transplantation; vascular resistance

Received for publication: 23.10.08
Accepted in revised form: 7. 1.09


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