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Paper Information

Title: 

"ROLE OF RESISTIVE INDEX MEASUREMENT IN DIAGNOSIS OF ACUTE REJECTION AFTER RENAL TRANSPLANT"

Type: PAPER
Author(s): MANSOORI DARYOUSH,POURMAND GHOLAMREZA,MEHRSAI ABDOLRASOL,TAHERIMAHMOUDI MOHSEN
 
 
 
Name of Seminar: CONGREH ANJOMAN UROLOGY IRAN
Type of Seminar:  CONGRESS
Sponsor:  ANJOMAN OROLOGY
Date:  2005Volume 8
 
 
Abstract: 

PROPOSE: TO EVALUATE THE ROLE OF RENAL RESISTIVE INDEX (RI) IN THE DIAGNOSIS OF ACUTE REJECTION AFTER SUCCESSFUL RENAL TRANSPLANTATION.
METHODS & MATERIALS: IN A PROSPECTIVE STUDY FROM JAU. 2000 TO AGU.2001, 101 RENAL TRANSPLANTATION (MEAN AGE OF 39 YEARS, 74 MALE AND 25 FEMALE) WERE DONE IN OUR CENTER. RESISTIVE INDEX MEASURED IN ALL PATIENTS BY DOPPLER SONOGRAPHY 3 DAYS, 7 DAYS AND AT 1, 3, 6 MONTHS AND AT THE TIME OF GRAFT DYSFUNCTION (INCREASE OF MORE THAN 1 MG/DL IN CREATININE LEVEL) AFTER OPERATION. ALL MEASUREMENTS WERE DONE BY A SINGLE SONOGRAPHIST AND IN THE SAME CONDITION. THE NORMAL LIMIT OF RI PERSUMED TO BE LESS THAN 0.70. STATICAL ANALYSIS WAS DONE BY T-TEST IN SPSS SOFT-WARE COMPUTER PROGRAM. THE STUDY WAS ACCEPTED BY ETHICAL COMMITTEE OF UNIVERSITY AND ALL PATIENTS GAVE THEIR INFORMED CONSENT PRIOR TO INCLUSION TO STUDY.
RESULTS: THIRTY-THREE EPISODES OF ACUTE REJECTION IN 27 PATIENTS (32%), 10 HIGH BLOOD LEVEL OF CYCLOSPORINE IN 8 PATIENTS AND 5 EPISODES OF ISCHEMIC TUBULAR NECROSIS (ATN) AND 3 EPISODES OF RENAL ARTERY THROMBOSIS DETECTED IN CASE OF GRAFT DYSFUNCTION IN THESE PATIENTS. MEAN RI WAS 0.606+/-0.065 (0.45-0.75) IN NORMAL GRAFT FUNCTION GROUP. MEAN RI WAS 0.866+/-0.083 (0.69-1.1) IN REJECTION GROUP (P<0.05). IN 32 EPISODES OF REJECTION RESISTIVE INDEX WERE HIGHER THAN NORMAL (>0.70) AND IN ONE EPISODES THE RI WERE IN NORMAL LIMIT. NORMAL RI DETECTED IN PATIENT WITH HISTORY OF ANOTHER EPISODE OF REJECTION. MEAN RI WAS 0.642+/-0.060 (0.56-0.72) (P>0.05) IN ATN GROUP. ONLY ONE PATIENT WITH ATN HAD RI MILDLY ELEVATED (0.72) AND THE OTHERS HAD NORMAL RI. MEAN RI WAS 0.622+/-0.056 (0.49-0.69) (P>0.05) IN HIGH BLOOD CYCLOSPORINE LEVEL GROUP. NO ONE OF THE PATIENTS WITH HIGH SERUM LEVEL OF CYCLOSPORINE HAD ELEVATED RI. ONLY 2 PATIENTS HAD MILD ELEVATION OF RI IN SPITE OF NORMAL GRAFT FUNCTION (0.75 AND 0.73). BOTH OF THESE PATIENT HAD POST TRANSPLANT DIABETES MELLITUS (PTDM).
CONCLUSION: RESISTIVE INDEX IS SIGNIFICANTLY HIGHER IN PATIENTS WITH ACUTE REJECTION AND DO NOT INCREASE IN PATIENTS WITH ATN OR CYCLOSPORINE TOXICITY AFTER RENAL TRANSPLANTATION. RI MEASUREMENT IS A NON-INVASIVE DIAGNOSTIC METHOD WHICH PROVIDES FLOW-METRIC QUANTITATIVE PARAMETERS FOR THE HEMODYNAMIC ASSESSMENT OF THE RENAL TRANSPLANT WITH A CERTAIN SENSIVITY.

 
Keyword(s): RENAL TRANSPLANT, REJECTION, RESISTIVE INDEX
 
 
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