J Korean Soc Med Ultrasound.  1998 Sep;17(3):201-206.

Value of Serial Changes of Resistive Indices in Predicting Acute Rejection of Renal Allografts

• Lee TH
• Koh BH
• Song SY
• Cho OK
• Rhim HC
• Kim YS
• Hahm CK
• Joo KB
• Lee HS
• Kwak JY
• Kwon OJ

Abstract

PURPOSE: The purpose of this study was to evaluate serial changes of Resistive Indices(RI) from interlobar arteries in renal transplant and to estimate its accuracy in predicting acute allograft rejection. MATERIALS & METHODS: Total 32 patients, who underwent post-transplantation Doppler ultrasonogram from July. 1995 to February. 1997, were included in this study. Nineteen patients had acute allograft rejection and 13 patients were control group, who had stable post-operative clinical course. Doppler ultrasonography was done and Resistive Indices of interloabr arteries were obtained at first and fifth postoperative day in all patients. In rejection group, late RI was obtained when rejection was suspected clinically (in average 19 days after transplatation) and was compared with initial RI(mean value of first and fifth day). In control group, late RI was obtained at discharge(average 35 days after transplantation) and was compared with initial RI. Statistic analysis was done using Student's T-test(paired test).
RESULTS
In rejection troup, late RI (0.78 +/- 0.07) was significantly higher than initial RI(p 0.01) and the increase of RI was 0.12 +/- 0.10. With the serial change of RI greater than 0.05, 89% sensitivity and 69% specificity were obtained for the prediction of acute rejection. In the patients with Late RI between 0.70 and 0.79, 86% sensitivity and 75% specificity were obtained when cut-off point of RI increase is 0.05.
CONCLUSION
Serial changes of RI from interlobar arteries in transplanted kidney was valuable to predict acute allograft rejection.

MeSH Terms

Allografts*
Arteries
Humans
Kidney
Sensitivity and Specificity
Ultrasonography
Ultrasonography, Doppler