Detection of transplant renal artery stenosis: determining normal velocities at the renal artery anastomosis

Kristin A. Robinson, J. Scott Kriegshauser, Nirvikar Dahiya, Scott W. Young, Christopher D. Czaplicki, Maitray D. Patel

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: Renal artery anastomosis peak systolic velocity (RAA PSV) exceeding 250 cm/s and a ratio of the renal artery to the adjacent external iliac artery (RAA:EIA) exceeding 1.8 historically suggest significant transplant renal artery stenosis (TRAS). However, the range of RAA PSV in transplants without TRAS has not been established. Methods: A retrospective review of renal transplants at a single institution over 5 years was performed identifying patients without graft dysfunction, failure, or refractory hypertension. RAA PSV obtained during interval postoperative sonograms was recorded. Results: Of 1141 patients, 844 met the inclusion criteria. Mean RAA PSV for 377 patients evaluated within 2 days of transplant measured 195 cm/s; RAA PSV exceeded 250 cm/s in 97 patients (26%). Mean RAA PSV for 820 patients evaluated 1-month post-transplant measured 206 cm/s; RAA PSV exceeded 250 cm/s in 224 patients (27%). Mean RAA PSV for 785 patients evaluated 4-month post-transplant measured 203 cm/s; RAA PSV exceeded 250 cm/s in 201 patients (26%). Mean RAA PSV for 766 patients evaluated 1-year post-transplant measured 189 cm/s; RAA PSV exceeded 250 cm/s in 141 patients (18%). At each of the given time points, 24%–34% of normal patients had RAA-to-EIA ratios greater than 1.8. Conclusion: Approximately, 26% of patients without TRAS have RAA PSV > 250 cm/s in the first 9 months, and 18% do at 1 year. Similar findings also occurred with regards to the RAA-to-EIA ratio threshold of 1.8. In isolation, a PSV over 250 cm/s or 1.8 ratio threshold for suspicion of TRAS will lead to a large number of false-positive assessments.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalAbdominal Radiology
DOIs
StateAccepted/In press - Aug 18 2016

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Renal Artery Obstruction
Renal Artery
Transplants
Iliac Artery

Keywords

  • Normal transplant renal artery velocities
  • Transplant renal artery peak systolic velocity
  • Transplant renal artery stenosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology
  • Radiological and Ultrasound Technology

Cite this

Detection of transplant renal artery stenosis : determining normal velocities at the renal artery anastomosis. / Robinson, Kristin A.; Kriegshauser, J. Scott; Dahiya, Nirvikar; Young, Scott W.; Czaplicki, Christopher D.; Patel, Maitray D.

In: Abdominal Radiology, 18.08.2016, p. 1-6.

Research output: Contribution to journalArticle

Robinson, Kristin A. ; Kriegshauser, J. Scott ; Dahiya, Nirvikar ; Young, Scott W. ; Czaplicki, Christopher D. ; Patel, Maitray D. / Detection of transplant renal artery stenosis : determining normal velocities at the renal artery anastomosis. In: Abdominal Radiology. 2016 ; pp. 1-6.
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abstract = "Purpose: Renal artery anastomosis peak systolic velocity (RAA PSV) exceeding 250 cm/s and a ratio of the renal artery to the adjacent external iliac artery (RAA:EIA) exceeding 1.8 historically suggest significant transplant renal artery stenosis (TRAS). However, the range of RAA PSV in transplants without TRAS has not been established. Methods: A retrospective review of renal transplants at a single institution over 5 years was performed identifying patients without graft dysfunction, failure, or refractory hypertension. RAA PSV obtained during interval postoperative sonograms was recorded. Results: Of 1141 patients, 844 met the inclusion criteria. Mean RAA PSV for 377 patients evaluated within 2 days of transplant measured 195 cm/s; RAA PSV exceeded 250 cm/s in 97 patients (26{\%}). Mean RAA PSV for 820 patients evaluated 1-month post-transplant measured 206 cm/s; RAA PSV exceeded 250 cm/s in 224 patients (27{\%}). Mean RAA PSV for 785 patients evaluated 4-month post-transplant measured 203 cm/s; RAA PSV exceeded 250 cm/s in 201 patients (26{\%}). Mean RAA PSV for 766 patients evaluated 1-year post-transplant measured 189 cm/s; RAA PSV exceeded 250 cm/s in 141 patients (18{\%}). At each of the given time points, 24{\%}–34{\%} of normal patients had RAA-to-EIA ratios greater than 1.8. Conclusion: Approximately, 26{\%} of patients without TRAS have RAA PSV > 250 cm/s in the first 9 months, and 18{\%} do at 1 year. Similar findings also occurred with regards to the RAA-to-EIA ratio threshold of 1.8. In isolation, a PSV over 250 cm/s or 1.8 ratio threshold for suspicion of TRAS will lead to a large number of false-positive assessments.",
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author = "Robinson, {Kristin A.} and Kriegshauser, {J. Scott} and Nirvikar Dahiya and Young, {Scott W.} and Czaplicki, {Christopher D.} and Patel, {Maitray D.}",
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T2 - determining normal velocities at the renal artery anastomosis

AU - Robinson, Kristin A.

AU - Kriegshauser, J. Scott

AU - Dahiya, Nirvikar

AU - Young, Scott W.

AU - Czaplicki, Christopher D.

AU - Patel, Maitray D.

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N2 - Purpose: Renal artery anastomosis peak systolic velocity (RAA PSV) exceeding 250 cm/s and a ratio of the renal artery to the adjacent external iliac artery (RAA:EIA) exceeding 1.8 historically suggest significant transplant renal artery stenosis (TRAS). However, the range of RAA PSV in transplants without TRAS has not been established. Methods: A retrospective review of renal transplants at a single institution over 5 years was performed identifying patients without graft dysfunction, failure, or refractory hypertension. RAA PSV obtained during interval postoperative sonograms was recorded. Results: Of 1141 patients, 844 met the inclusion criteria. Mean RAA PSV for 377 patients evaluated within 2 days of transplant measured 195 cm/s; RAA PSV exceeded 250 cm/s in 97 patients (26%). Mean RAA PSV for 820 patients evaluated 1-month post-transplant measured 206 cm/s; RAA PSV exceeded 250 cm/s in 224 patients (27%). Mean RAA PSV for 785 patients evaluated 4-month post-transplant measured 203 cm/s; RAA PSV exceeded 250 cm/s in 201 patients (26%). Mean RAA PSV for 766 patients evaluated 1-year post-transplant measured 189 cm/s; RAA PSV exceeded 250 cm/s in 141 patients (18%). At each of the given time points, 24%–34% of normal patients had RAA-to-EIA ratios greater than 1.8. Conclusion: Approximately, 26% of patients without TRAS have RAA PSV > 250 cm/s in the first 9 months, and 18% do at 1 year. Similar findings also occurred with regards to the RAA-to-EIA ratio threshold of 1.8. In isolation, a PSV over 250 cm/s or 1.8 ratio threshold for suspicion of TRAS will lead to a large number of false-positive assessments.

AB - Purpose: Renal artery anastomosis peak systolic velocity (RAA PSV) exceeding 250 cm/s and a ratio of the renal artery to the adjacent external iliac artery (RAA:EIA) exceeding 1.8 historically suggest significant transplant renal artery stenosis (TRAS). However, the range of RAA PSV in transplants without TRAS has not been established. Methods: A retrospective review of renal transplants at a single institution over 5 years was performed identifying patients without graft dysfunction, failure, or refractory hypertension. RAA PSV obtained during interval postoperative sonograms was recorded. Results: Of 1141 patients, 844 met the inclusion criteria. Mean RAA PSV for 377 patients evaluated within 2 days of transplant measured 195 cm/s; RAA PSV exceeded 250 cm/s in 97 patients (26%). Mean RAA PSV for 820 patients evaluated 1-month post-transplant measured 206 cm/s; RAA PSV exceeded 250 cm/s in 224 patients (27%). Mean RAA PSV for 785 patients evaluated 4-month post-transplant measured 203 cm/s; RAA PSV exceeded 250 cm/s in 201 patients (26%). Mean RAA PSV for 766 patients evaluated 1-year post-transplant measured 189 cm/s; RAA PSV exceeded 250 cm/s in 141 patients (18%). At each of the given time points, 24%–34% of normal patients had RAA-to-EIA ratios greater than 1.8. Conclusion: Approximately, 26% of patients without TRAS have RAA PSV > 250 cm/s in the first 9 months, and 18% do at 1 year. Similar findings also occurred with regards to the RAA-to-EIA ratio threshold of 1.8. In isolation, a PSV over 250 cm/s or 1.8 ratio threshold for suspicion of TRAS will lead to a large number of false-positive assessments.

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KW - Transplant renal artery stenosis

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