Real-time ultrasound evaluation of renal transplant failure during the early postoperative period.

In a prospective clinical trial 385 ultrasound (US) examinations were performed on 50 renal allograft patients. Baseline sonograms were obtained within 24 hrs of transplantation, and serial US examinations were performed in two to three days intervals during hospital recovery. 24 out of 28 cases of acute rejections (85.7%) were detected by US with an 8% false positive rate. Using statistical analysis, enlarged and sonolucent pyramids, areas of decreased parenchymal echogenicity and an increase in anterior-posterior diameter of the organ, proved to be the best US-rejection criteria. Fine needle aspiration cytology revealed a high rate of false positive rejection diagnosis (23.8%). The results demonstrate that US is a valuable diagnostic aid in the evaluation of postoperative renal transplant failure.