Upcoming Events
Log In
Pricing
Free Trial

Complications Summary

HIDE
PrevNext

0:00

This table summarizes some of

0:03

the common complications that can be seen with

0:06

the renal transplants and I've sort

0:09

of divided them according to the time frame in

0:12

which you can see them and I think the time frame becomes very important because

0:15

a lot of these complications may have

0:18

similar Imaging finding in so you could probably narrow your

0:21

differential can understand, you know, when that complication occurring

0:24

and what time frame and so the typical things you're

0:27

going to see sort of in the immediate setting IE

0:30

up to one week post transplant are the

0:33

following a q-tube learn acrosis, which on Imaging will really

0:36

just manifest as high resistive indices. If

0:39

it's very severe you can see reversedologic flow

0:42

in the renal arteries, but often it's just

0:45

High resistive Industries typically around one to three days post transplant

0:48

rejection, you know, I put hyper acute

0:51

here. This is something you've seen the operating room essentially so we can

0:54

ignore that for now but a cute is what we've talked about an acute.

0:57

We'll also manifest as high resistive indices a very

1:00

You can have reverse diastolic flow in the renal arteries. And typically

1:03

you'll see that about a week. You can see

1:06

it within a week. But most often you'll see in the second column about a

1:09

week to one month post transplant.

1:11

Renal artery renal vein thrombosis. If it does happen at all tends to

1:14

happen very very early on within the first week and typically within the first

1:17

couple of days and then sometimes compartment syndrome which

1:20

is situation where the renal transplant is actually placed into the

1:23

pelvic cavity in a

1:26

space that's too small to host it and so that way

1:29

you get Mass Effect upon the renal transplant from

1:32

that small compartment and can cause Imaging findings that

1:35

are quite similar to tubular and necrosis with high

1:38

resistive indices and very severe reverse diastolic

1:41

flow.

1:42

In the one week to one month post transplant you start

1:45

to see high resistive indices, you're dealing with acute rejection. That's

1:48

the sort of time period in which you may sometimes see

1:51

renal vein thrombosis can happen a little bit more delayed urinary tract

1:54

obstructions can also occur in this setting whether it's due

1:57

to a stone or other ideologies and then one month

2:00

post transplant, you're really dealing with chronic rejection

2:03

medication toxicity, which from an Imaging perspective

2:06

just manifest as high resistive indices to point

2:09

eight or above you tend to see renal arteries to gnosis in this

2:12

setting if at all where you see Tardis parvis waveforms within the

2:15

transplant renal parenchyma, and then at the

2:18

area of narrowing you see color aliasing High

2:21

Velocity flow, which is about three and a half times more

2:24

than the artery proceeding it renal veins

2:27

stenosis, very very uncommon and no really

2:30

set criteria for it avf. Pseudo aneurysms

2:33

typically will occur in the post biopsy setting which typically happen

2:36

about one month post transplant if there's some

2:39

persistent complications and patience, although of course

2:42

It can happen at any time and neoplasm. If you see them

2:45

tend to happen more than one month Outpost transplant, but

2:48

within that range it typically is within the

2:51

first year. So you end up seeing your neoplasm these

2:54

can occur at any time. You can get a UTI at any

2:57

time pilot nephritis. So beyond the lookout for it collections can

3:00

occur at any time as well. You can get an abscess maybe associated

3:03

with the UTI hematomas can

3:06

occur at any time but typically occurs early in the process. You

3:09

see fluid hematocrit levels associated with them uranomas

3:12

also typically occur within the first week. They're

3:15

typically located within between the transplant and

3:18

the bladder and they tend to look a little bit cleaner than

3:21

some of these other collections live the seals occur a couple

3:24

of weeks out 40 weeks out. They typically look more complex with

3:27

septations within them. And so these are some of the complications

3:30

that one can see within the

3:33

real transplant and some of the time frames in which they can occur.

Report

Faculty

Mahan Mathur, MD

Associate Professor, Division of Body Imaging; Vice Chair of Education, Dept of Radiology and Biomedical Imaging

Yale School of Medicine

Tags

Vascular

Ultrasound

Non-infectious Inflammatory

Neoplastic

Kidneys

Infectious

Idiopathic

Iatrogenic

Genitourinary (GU)

Body