TY - CHAP M1 - Book, Section TI - Vascular Imaging A1 - Volpacchio, Mariano M A1 - D’Agostino, Catherine A A1 - Bakken, Sofia A1 - Palestro, Christopher J A1 - Warshawsky, Robin J A1 - Grimaldi, Gregory M A1 - Pellerito, John S A1 - Molmenti, Ernesto P A2 - Molmenti, Ernesto Pompeo Y1 - 2023 N1 - T2 - Molmenti’s Kidney and Pancreas Transplantation: Operative Techniques and Medical Management, 2e AB - Ultrasound evaluation is a fundamental part of the vascular study of the transplant kidneyThis is especially true with the use of Doppler capabilitiesColor Doppler allows depiction of the vessels and their anastomosesDuplex Doppler allows forHemodynamic evaluation through spectral analysisAssessment of multiple vascular functional parametersNoninvasive screening and detection of multiple potential abnormalities that may be ultimately be confirmed with computed tomography (CT) angiography, magnetic resonance (MR) angiography, or classic angiography (still the golden standard)Although the resistive index (RI) was initially regarded as a specific parameter of graft rejection, subsequent studies and experience proved it could not fulfill its original promise. It is probably associated with both resistance and complianceMean normal RI is 0.6 and a value > 0.8 is considered abnormalRI is currently considered a nonspecific marker of graft dysfunctionIt is usually elevated (> 0.8) in acute rejection, acute tubular necrosis, calcineurin inhibitor toxicity, and renal vein thrombosisIt is usually decreased in instances of renal artery stenoses, arteriovenous (AV) communicationsWe routinely obtain a duplex Doppler ultrasound study in the immediate postoperative period upon arrival of the recipient to the postanesthesia care unit SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/03/29 UR - accesssurgery.mhmedical.com/content.aspx?aid=1194190151 ER -