Preoperative evaluation of iliac blood vessels for first kidney transplant recipients: Combination of conventional and contrast-enhanced ultrasonography

Article type: Research Article

Authors: Yang, Wen-qi^{a; 1} | Cui, Xiao-lan^{a; 1} | Zhang, Ming^b | Yuan, Xiao-dong^b | Ying, Liang^b | Li, Feng-hua^a | Li, Hong-li^{a; *}

Affiliations: [a] Department of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China | [b] Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

Correspondence: [*] Corresponding author: Hong-li Li, PhD, Department of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 160 Pujian Road, Pudong District, Shanghai 200127, China. Tel.: +86 02168383211; Fax: +86 02168383211; E-mail: [email protected].

Note: [1] Wen-qi Yang and Xiao-lan Cui contributed equally to this work.

Abstract: OBJECTIVE:To assess iliac blood vessels using conventional ultrasound (US) and contrast-enhanced ultrasonography (CEUS) before kidney transplantation (KT) and determine whether US findings related to post-transplant outcomes. METHODS:A total of 119 patients received US and CEUS before KT waiting-list acceptance. The preoperative iliac blood hemodynamics and vascular conditions were evaluated. The operative strategy and follow-up outcomes were recorded. Logistic regression and correlation analysis were used. The accuracy in determining the patency of iliac blood vessels was calculated before and after the injection of contrast materials. RESULTS:CEUS can help to significantly improve the visualization of the internal iliac artery, but there was no significant correlation with post-transplant outcomes. In terms of accuracy, there were significant differences in determining the patency of internal iliac arteries between conventional US and CEUS (60.5% and 100%, p < 0.001). The surgical strategy of one patient was regulated and two patients were excluded from KT according to US findings. CONCLUSIONS:Compared with conventional US, CEUS helps to improve the visualization of the internal iliac artery. Conventional US and CEUS have the potential to serve as effective methods to evaluate anatomy and hemodynamics of iliac vessels and have a potential value while defining clinical algorithms in surgery decision-making.

Keywords: Contrast-enhanced ultrasonography, ultrasound, kidney transplantation, iliac artery

DOI: 10.3233/CH-201054

Journal: Clinical Hemorheology and Microcirculation, vol. 78, no. 2, pp. 139-149, 2021