Functional MRI detects perfusion impairment in renal allografts with delayed graft function.

Am J Physiol Renal Physiol. 2015 Apr 29;:ajprenal.00064.2015

Authors: Hueper K, Gueler F, Bräsen JH, Gutberlet M, Jang MS, Lehner F, Richter N, Hanke N, Peperhove MJ, Martirosian P, Tewes S, Vo Chieu VD, Großhennig A, Haller H, Wacker F, Gwinner W, Hartung D

Abstract
Delayed graft function (DGF) after kidney transplantation is not uncommon, and it is associated with long-term allograft impairment. Our aim was to compare renal perfusion changes measured with non-invasive functional MRI in patients early after kidney transplantation to renal function and allograft histology in biopsy samples. Forty-six patients underwent MRI 4 to 11 days after transplantation. Contrast-free MRI renal perfusion images were acquired using an arterial spin labelling technique. Renal function was assessed by eGFR, and renal biopsies were performed when indicated within 5 days of MRI. 26/46 patients had DGF. Of these, 9 patients had acute rejection (including borderline), and 8 had other changes (e.g., tubular injury or glomerulosclerosis). Renal perfusion was significantly lower in the DGF-group compared to the group with good allograft function (231±15 vs. 331±15 ml/(min*100g), p<0.001). Living donor allografts exhibited significantly higher perfusion values compared to deceased donor allografts (p<0.001). Renal perfusion significantly correlated with eGFR (r=0.64, p<0.001), resistance index (r=-0.57 p<0.001), and cold ischemia time (r=-0.48, p<0.01). Furthermore, renal perfusion impairment early after transplantation predicted inferior renal outcome and graft loss. In conclusion, non-invasive functional MRI detects renal perfusion impairment early after kidney transplantation in patients with DGF.

PMID: 25925250 [PubMed - as supplied by publisher]