Journal of Ultrasound in Medicine, Vol 18, Issue 7 497-502, Copyright © 1999 by American Institute of Ultrasound in Medicine
Doppler ultrasonographic evaluation of the early changes in renal resistive index in cirrhotic patients undergoing liver transplantation
M. Pompili, G. L. Rapaccini, F. De Luca, S. Agnes, A. W. Avolio, M. Covino, C. Trombino, M. Castagneto and G. Gasbarrini
Cattedra di Medicina Interna II, Universita Cattolica del Sacro Cuore, Rome, Italy.
Renal vasoconstriction commonly occurs in decompensated liver cirrhosis and
is entirely reversible after hepatic transplantation. In this study we
evaluated by Doppler ultrasonography the changes of renal vascular
resistance occurring during the first month after transplantation. In 16
cirrhotic patients the intrarenal resistive index at the level of
interlobar arteries and the blood urea nitrogen and serum creatinine levels
were measured before (range, 1 to 34 days) and after transplantation (days
1, 3, 7, 14, 30). Before transplantation the median resistive index value
was 0.69 (95% CI, 0.65 to 0.71) and eight of 16 patients showed abnormal
values (0.70 or more). After transplantation, the median resistive index
was significantly decreased on all the evaluation days, and no patient had
abnormal values on posttransplantation day 7. No significant correlation
was found between resistive index and serum creatinine or blood urea
nitrogen levels. Doppler ultrasonography is a simple tool to evaluate the
recovery of normal intrarenal arterial resistance levels after liver
transplantation. One week appears to be the optimal timing to evaluate the
renal resistive index in the posttransplantation period.
