•
The Radiographic Size of Renal
Transplants 1
•
Diagnostic Radiology
Francis A. Burgener, M.D. and Stephen I. Schabel, M.D. The lengths of 55 renal transplants outlined by metallic clips were measured on serial abdominal radiographs up to 3 years after operation. The range of normal transplant size was defined as the mean value ±2 standard deviations. Using this definition, the maximum increase in length was 5 % at 10 days, 10% at 1 month, and 1 % additional for each month in the first year. The normal maximum rate of increase in renal length was 0.5% per day, found only in the immediate postoperative period. Sixty per cent of transplants with severe rejection had either an abnormal length or growth rate or both. In chronic rejection and other complications, size and growth rate were rarely abnormal. An abnormal decrease in renal length was not seen with any complication. INDEX TERMS:
Kidneys, radiography. Kidneys, size. Kidneys, transplantation
Radiology 117:547-550, December 1975
•
A NY
CHANGE IN
• the size of a renal transplant can
f t easily be followed on plain abdominal films when its margins are outlined by metallic clips; however, such changes may be difficult to interpret, since data in the literature are inconclusive. The purpose of this retrospective investigation is to analyze variation in the size of normal and abnormal renal transplants with time. PATIENT MATERIAL
Fifty patients (29 males and 21 females 13-57 years of age) in whom the transplanted kidney was outlined by metallic clips and for whom more than one abdominal radiograph [supine with a 101.6-cm (40-in.) SSD] was available were studied. Coned radiographs of the pelvis, oblique, prone, upright, and portable supine views of the abdomen, excretory urograms, and angiograms were examined but not included in the final analysis. Three of the 50 patients had two transplants and one had three. Thirty-six transplants came from cadavers and 19 from living relatives. All patients were followed up for up to three years. Two to 18 radiographs were available for each transplant. Fig. 1. Length of transplant estimated on abdominal radiograph by determining ratio A/B. The first obtained value is defined as 100 % and subsequent values compared to it. A = distance between upper- and lower-pole clips. B = Distance between parallel lines drawn through the superior portion of the acetabular roof and the iliac crest.
Normal Transplants
A transplant was considered to be normal when renal function remained stable during the radiographic followup period, with a creatinine clearance of greater than 60 ml/min. Intercurrent urinary tract infections, nonobstructing Iymphoceles, and signs of focal glomerulitis on renal biopsy (the latter usually present at transplantation) were disregarded, but no other major complications occurred. Eighteen transplants (10 from cadavers and 8 from living relatives) comprised this group. All had a base-line abdominal radiograph taken within the first
five days after operation and follow-up radiographs over at least a one-year period. Rejected Transplants
This group consisted of 20 transplants with severe
1 From the Department of Radiology, University of Rochester School of Medicine and Dentistry, Rochester, New York. Accepted for publicaelk tion in June 1975.
547
548
FRANCIS
~115
BURGE:NER AND STEPHEN
1 q!! ~ :trrj-l· I ) 110
105
1
100
~
95
~
~
1025 50 75 100
150
200
250
300
350
DAYS Fig. 2. Mean length ± 1 standard deviation of 18 normal transplants. The base-line value of each transplant was obtained within the first five days after surgery and defined as 100%.
130 ~125
The Radiographic Size of Renal
Transplants 1
•
Diagnostic Radiology
Francis A. Burgener, M.D. and Stephen I. Schabel, M.D. The lengths of 55 renal transplants outlined by metallic clips were measured on serial abdominal radiographs up to 3 years after operation. The range of normal transplant size was defined as the mean value ±2 standard deviations. Using this definition, the maximum increase in length was 5 % at 10 days, 10% at 1 month, and 1 % additional for each month in the first year. The normal maximum rate of increase in renal length was 0.5% per day, found only in the immediate postoperative period. Sixty per cent of transplants with severe rejection had either an abnormal length or growth rate or both. In chronic rejection and other complications, size and growth rate were rarely abnormal. An abnormal decrease in renal length was not seen with any complication. INDEX TERMS:
Kidneys, radiography. Kidneys, size. Kidneys, transplantation
Radiology 117:547-550, December 1975
•
A NY
CHANGE IN
• the size of a renal transplant can
f t easily be followed on plain abdominal films when its margins are outlined by metallic clips; however, such changes may be difficult to interpret, since data in the literature are inconclusive. The purpose of this retrospective investigation is to analyze variation in the size of normal and abnormal renal transplants with time. PATIENT MATERIAL
Fifty patients (29 males and 21 females 13-57 years of age) in whom the transplanted kidney was outlined by metallic clips and for whom more than one abdominal radiograph [supine with a 101.6-cm (40-in.) SSD] was available were studied. Coned radiographs of the pelvis, oblique, prone, upright, and portable supine views of the abdomen, excretory urograms, and angiograms were examined but not included in the final analysis. Three of the 50 patients had two transplants and one had three. Thirty-six transplants came from cadavers and 19 from living relatives. All patients were followed up for up to three years. Two to 18 radiographs were available for each transplant. Fig. 1. Length of transplant estimated on abdominal radiograph by determining ratio A/B. The first obtained value is defined as 100 % and subsequent values compared to it. A = distance between upper- and lower-pole clips. B = Distance between parallel lines drawn through the superior portion of the acetabular roof and the iliac crest.
Normal Transplants
A transplant was considered to be normal when renal function remained stable during the radiographic followup period, with a creatinine clearance of greater than 60 ml/min. Intercurrent urinary tract infections, nonobstructing Iymphoceles, and signs of focal glomerulitis on renal biopsy (the latter usually present at transplantation) were disregarded, but no other major complications occurred. Eighteen transplants (10 from cadavers and 8 from living relatives) comprised this group. All had a base-line abdominal radiograph taken within the first
five days after operation and follow-up radiographs over at least a one-year period. Rejected Transplants
This group consisted of 20 transplants with severe
1 From the Department of Radiology, University of Rochester School of Medicine and Dentistry, Rochester, New York. Accepted for publicaelk tion in June 1975.
547
548
FRANCIS
~115
BURGE:NER AND STEPHEN
1 q!! ~ :trrj-l· I ) 110
105
1
100
~
95
~
~
1025 50 75 100
150
200
250
300
350
DAYS Fig. 2. Mean length ± 1 standard deviation of 18 normal transplants. The base-line value of each transplant was obtained within the first five days after surgery and defined as 100%.
130 ~125
