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Renal Transplant

ORIGINATOR: Deborah L. Richert, BSVT, RDMS, RVT

REVIEW DATE: September 13, 2013

Renal Transplant Ultrasound Exam

  • Longitudinal renal transplant with maximum length and location labeled (e.g. RLQ/LLQ) (Transplant kidneys should be morphologically similar to a normal native kidney)
  • Longitudinal images of medial, mid, and lateral renal transplant
  • Transverse images upper, mid, and lower pole renal transplant
  • Longitudinal color and/or power Doppler images of the renal transplant to demonstrate the overall perfusion of the transplant (Look for areas of hypoperfusion)
  • Longitudinal bladder
  • Transverse bladder
  • Transplant renal artery: from iliac artery anastomosis to renal hilum – measure velocities at origin and distal renal artery (Provided flow in the iliac artery is normal, transplant renal artery velocities should be less than 200 cm/sec)
  • Transplant renal vein: from iliac vein anastomosis to renal hilum – show patency
  • Arcuate arteries: upper, mid, and lower pole images with color and spectral Doppler to measure the RI (resistive index) (Do not angle correct)

Renal Transplant Arcuate Artery RI Values:

  • Normal: < .80
  • Probably Abnormal: .80 - .90
  • Definitely Abnormal: > .90 
  • RI’s are nonspecific; they just indicate transplant dysfunction

Source: Mayo Clinic Renal Transplant Imaging Protocol and Jody Riherd, MD

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