Functional MRI detects perfusion impairment in renal allografts with delayed graft function.
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 noninvasive functional MRI in patients early after kidney transplantation to renal function and allograft histology in biopsy samples. Forty-six patients underwent MRI 4-11 days after transplantation. Contrast-free MRI renal perfusion images were acquired using an arterial spin labeling technique. Renal function was assessed by estimated glomerular filtration rate (eGFR), and renal biopsies were performed when indicated within 5 days of MRI. Twenty-six of 46 patients had DGF. Of these, nine patients had acute rejection (including borderline), and eight had other changes (e.g., tubular injury or glomerulosclerosis). Renal perfusion was significantly lower in the DGF group compared with the group with good allograft function (231 ± 15 vs. 331 ± 15 ml·min(-1)·100 g(-1), P < 0.001). Living donor allografts exhibited significantly higher perfusion values compared with 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, noninvasive functional MRI detects renal perfusion impairment early after kidney transplantation in patients with DGF.
['Hueper|Katja|K|', 'Gueler|Faikah|F|', 'Bräsen|Jan Hinrich|JH|', 'Gutberlet|Marcel|M|', 'Jang|Mi-Sun|MS|', 'Lehner|Frank|F|', 'Richter|Nicolas|N|', 'Hanke|Nils|N|', 'Peperhove|Matti|M|', 'Martirosian|Petros|P|', 'Tewes|Susanne|S|', 'Vo Chieu|Van Dai|VD|', 'Großhennig|Anika|A|', 'Haller|Hermann|H|', 'Wacker|Frank|F|', 'Gwinner|Wilfried|W|', 'Hartung|Dagmar|D|']
D000328:Adult D000368:Aged D051799:Delayed Graft Function D005260:Female D005919:Glomerular Filtration Rate D006084:Graft Rejection D006085:Graft Survival D006801:Humans D007668:Kidney D016030:Kidney Transplantation D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D010477:Perfusion D014184:Transplantation, Homologous
MRI delayed graft function kidney transplantation renal perfusion