Detection of renal allograft dysfunction with color Doppler flow ultrasound.

Thirty-six color Doppler flow (CDF) ultrasound studies were performed on 28 allograft kidneys to assess the capability of this technique in diagnosing transplant dysfunction through morphology and Doppler spectra. The composite score obtained from ultrasound images showed no statistical significance. Quantitative studies with Pulsatility Index (PI) and Resistive Index (RI) after localization of the arcuate, interlobar, segmental and main renal arteries by CDF revealed significant differences between normal functioning graft kidneys and the group of acute rejection, as well as the group of acute tubular necrosis (ATN) (P < 0.05). No apparent change was demonstrated in patients with chronic rejection. When PI was greater than 1.60 or RI was greater than 0.80, the transplant kidney was more likely to be rejected, though possibility of ATN should be considered. RI was easier to calculate, and correlated better than PI with the serum creatinine level. CDF expedited the Doppler spectrum study.