Ultrasound Findings in Renal Transplant Rejection

Ultrasound findings in 55 patients with kidney transplant were correlated with clinical course, laboratory tests and histology. In 48 patients acute or chronic rejection was present, in 8 of these associated with other parenchymal disease of the transplant (recurrent glomerulonephritis, tubular necrosis, pyelonephritis, cortical infarction, renal aspergillosis). One patient had acute postoperative tubular necrosis and six kidneys were normally functioning transplants. Of the diseased 49 kidneys, 7 had normal ultrasound appearances. In 44 kidneys (including 2 normally functioning transplants), the echogenicity of the renal parenchyma showed some abnormalities. The most frequent finding was either local or diffuse enlargement of hypoechoic medulla, associated with increased cortical echogenicity.