Prognostic value of reverted diastolic flow during initial of kidney transplantation

We report nine cases of kidney transplantation in five adults and four children who presented sustained reversal of the diastolic flow in the immediate postoperative period. Five patients developed early acute rejection, another presented severe acute rejection of somewhat later onset one developed renal vein thrombosis and the remaining two, distal renal artery thrombosis. In the cases of acute rejection, an inverted M pattern was observed in four cases and a flat pattern in two. The patient with renal vein thrombosis presented an inverted M pattern and the patterns in the two cases of distal renal artery thrombosis were flat and M shaped, respectively. In the cases of acute rejection, regardless of the pattern observed, it was initially possible to detect venous flow, which later disappeared, and was accompanied by ruptured kidney in two cases. Therefore, the morphology of reversed diastolic flow doses not aid in differentiating among early acute rejection, renal vein thrombosis and critical stenosis or thrombosis of the renal artery. The initial observation of venous flow, which later tends to disappear, is of greater interest in cases of rejection. (Author) 19 refs