Doppler color ultrasonography in the assessment of double kidney transplantation]

OBJECTIVE: In our Transplant Centre, in the last three years, twelve patients with chronic kidney disease underwent a "double kidney" transplant according to Masson technique. Our purpose is the evaluation of ultrasonography and echo-colorDoppler ultrasound in the diagnosis of possible clinical and surgical complications of "double kidney" transplant. PATIENTS AND METHODS: The "double kidney" transplant inclusion criteria are the following: donor age > 70 yrs; glomerulosclerosis > 20%; histological score (according to Kandinsky) > 4 and < 6. In our centre, from January 1998 to December 2001, we made 68 kidney transplantations from marginal donors, 12 of them were "double transplant". Mean donor age was 74.3 +/- 5.3 (70-82). Renal function was determined by detection of serum creatinine; every single patient underwent to ultrasonography evaluation of grafts during follow-up. RESULTS: Mean follow-up is 10 +/- 4.6 months (6-18); mean value of donor's serum creatinine 1.5 +/- 0.6 mg/dl. Delayed Graft Function (DGF) rate was 50%; no case of Primary Non Function (PNF) and Acute Rejection was found. Patients with DGF (group A) had a Resistance Index (IR) > 0.80 (mean 0.82); patients without DGF (group B) had an IR < 0.80 (mean 0.68 and 0.65) (p < 0.05). All patients underwent an eco colorDoppler evaluation after 3 and 6 months; in both groups (A and B) IR was, respectively, 0.75 and 0.71. Surgical adverse events were 41.6% (5/12): 3 urinary obstructions; 1 thrombosis of renal vein; 1 pelvic lymphocele. In all these patients the first diagnostic step was ultrasonography. Ultrasonography, in "double transplant" as in single one, have a very important role in post-transplant evaluation of DGF and surgical complications.