Pictorial Review of Paediatric Renal Transplant Vascular Complications

Additional risk factors include hypotension, multiple renal arteries, and unidentified intimal flaps, young age of the recipient, young age of the deceased donor, prolonged cold ischaemic time, history of transplantation, and presence of acute tubular necrosis. [4] In cases where ultrasonographic id...

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Bibliographic Details
Published in:	Hong Kong journal of radiology : HKJR = Xianggang fang she ke yi xue za zhi Vol. 23; no. 3; pp. 227 - 232
Main Authors:	Ng, CWK, Yeung, JTH, Pan, KNY, Luk, WH, Liu, DCY, Ma, ALT, Tong, PC, Chan, THF
Format:	Journal Article
Language:	English
Published:	Hong Kong Hong Kong Academy of Medicine 01-09-2020
Subjects:	Creatinine Flow velocity Hypertension Ischemia Kidney transplants Pediatrics Risk factors Thrombosis Ultrasonic imaging Veins & arteries
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Summary:	Additional risk factors include hypotension, multiple renal arteries, and unidentified intimal flaps, young age of the recipient, young age of the deceased donor, prolonged cold ischaemic time, history of transplantation, and presence of acute tubular necrosis. [4] In cases where ultrasonographic identification of the main renal artery is challenging due to technical factors such as postoperative gas limiting the acoustic window or a lack of operator experience, magnetic resonance (MR) or contrast computed tomography (CT) angiogram can provide a definitive diagnosis. Ultrasound scan on day 10 showed no blood flow in the graft kidney on (a) colourand (b) power Doppler studies. (c, d) Contrast-enhanced computed tomography showed no contrast enhancement in the graft kidney whilesatisfactory contrast opacification of the inferior vena cava and aorta and bilateral iliac vessels were both seen (solid arrows). Creatinine was persistently elevated.Ultrasound showed markedly reduced graft kidney perfusion.Renal vein colour flow was absent. (a) A thrombosed renal veinwas seen as a hypoechoic tubular structure in the renal hilum.(b, c) Contrast computed tomography showed a hyperdensenon-enhancing, distended renal vein (white arrows) compatiblewith renal vein thrombosis.
ISSN:	2223-6619 2307-4620
DOI:	10.12809/hkjr2017011