Objective: To evaluate the association between the value of the arterial resistance index (RI) measured by Doppler at the month after transplantation, and the loss of graft. Secondary outcomes of loss greater than or equal to 50% of renal function, eath with functioning graft, biopsy findings (inflammation, hyalinosis, rejection, interstitial fibrosis - tubular atrophy, IFTA) are reported.
Methods: A cohort study of 66 patients, who underwent renal transplantation at San José Hospital of Bogotá between October 2007 and April 2011. The RI of the hilar artery was measured by Doppler ultrasound at the month post-transplant. Most patients had follow-up until the second year. We describe the cumulative incidence of renal graft loss, loss greater than or equal to 50% of the glomerular filtration rate. At the second year after transplantation, rejection, IFTA, hyalinosis and documented inflammation were reported in protocol biopsies. Association analysis was performed on the histological outcomes.
Results: only 2 cases of renal graft loss were reported, belonging to the group with normal RI (3.8%). At 3 years of follow-up, 5 patients had lost more than 50% of GFR compared to baseline, 4 occurred in patients with RI <0.8, 2 of them (3.7%) ocurred in the first year and only one patient with RI> 0.8 ocurred at 3 years. The median GFR at 3 years of follow-up in both groups is greater than 60 ml / min. In the first year of follow-up 22 (47%) patients with normal RI had IFTA, and 7 (54%) with RI> 0.8 had IFTA. Hyalinosis was reported for 23% with RI> 0.8 and 25.5% with RI <0.8.
Conclusion: the outcome of the grafts depends not only on RI, but also on factors such as cold ischemia, induction and maintenance immunosuppressive treatment, degree of incompatibility between donor and recipient. Histopathological changes such as IFTA, inflammation, hyalinosis, were observed in both groups, suggesting that there are other factors stronger than the RI, which correlates with the occurrence of these findings.
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