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INTRA-OPERATIVE DOPPLER
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An intraoperative Doppler Duplex ultrasound evaluation of the donor and recipient vessels can be obtained to document satisfactory flow after the kidney has been placed in the position where it will lay after closure of the abdomen.
If flow is not satisfactory, consider:
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DUPLEX DOPPLER ULTRASOUND EVALUATION
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A duplex Doppler ultrasound imaging study of the transplant kidney in the recovery room immediately after transplantation will evaluate and document:
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Adequate arterial and venous flow in the transplant renal vessels (both intra and extra parenchymal)
Flow at the anastomoses
Absence of hydronephrosis in the transplant kidney
Adequate arterial and venous flow in the recipient vessels used for implantation of the allograft
Collections (absent, present, actively expanding)
Baseline findings that can serve for comparison with future studies.
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ARTERIAL FLOW VELOCITIES
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Immediate postoperative period
Short, intermediate, and long term postoperative period
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RI range: 0–1 (or 0–100%)
Normal arterial RI: 0.5–0.8
Low arterial RI (<0.5) suggestive of
impaired flow (arterial strictures, kinks, twists, thromboses, external arterial compression)
arteriovenous fistulae
Elevated arterial RI (>0.8) suggestive of
Increased parenchymal resistance (ATN, rejection, edema),
Impaired outflow (venous thromboses external venous compression)
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ABSENT OR SEVERELY IMPAIRED FLOW TO THE TRANSPLANTED KIDNEY
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Constitutes an emergency
Can result from: