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Renal transplant imaging using magnetic resonance angiography with a nonnephrotoxic contrast agent.

Publication ,  Journal Article
Bashir, MR; Jaffe, TA; Brennan, TV; Patel, UD; Ellis, MJ
Published in: Transplantation
July 15, 2013

BACKGROUND: In renal allograft recipients presenting with graft dysfunction, it is critical to determine the patency of the transplant vasculature to guide clinical management. Conventional modalities such as Doppler ultrasound, contrast-enhanced computed tomography, magnetic resonance angiography (MRA), and noncontrast MRA are each of limited use because of technical factors and toxicity of standard contrast agents. The purpose of this study was to retrospectively review our institutional experience with renal transplant MRA using ferumoxytol (a nonnephrotoxic medication) as a contrast agent and evaluate its use in the assessment of allograft vascular patency in patients with graft dysfunction, either delayed or slow graft function within hours to days after kidney transplantation or acute kidney injury weeks to months after kidney transplantation. METHODS: Sixteen kidney transplant recipients were retrospectively identified who underwent ferumoxytol-enhanced MRA after a nondiagnostic ultrasound for kidney dysfunction after transplantation. Image evaluation was performed by two radiologists, and clinical follow-up data were collected. RESULTS: In 1 of 16 subjects, MRA with ferumoxytol demonstrated complete arterial occlusion of an allograft. In 2 of 16 subjects, MRA detected moderate to severe anastomotic stenoses, which were confirmed at catheter angiography and successfully treated, resulting in the improvement of graft function. In 13 of 16 subjects, MRA demonstrated normal graft vasculature, and an alternative cause of allograft dysfunction was ultimately confirmed. CONCLUSIONS: Our study suggests that ferumoxytol-enhanced MRA may be a novel, safe method to accurately detect graft artery abnormalities in renal transplant recipients without the risk of nephrotoxicity, when transplant ultrasound is nondiagnostic.

Duke Scholars

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Published In

Transplantation

DOI

EISSN

1534-6080

Publication Date

July 15, 2013

Volume

96

Issue

1

Start / End Page

91 / 96

Location

United States

Related Subject Headings

  • Vascular Patency
  • Surgery
  • Retrospective Studies
  • Primary Graft Dysfunction
  • Postoperative Complications
  • Middle Aged
  • Male
  • Magnetic Resonance Angiography
  • Kidney Transplantation
  • Kidney
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bashir, M. R., Jaffe, T. A., Brennan, T. V., Patel, U. D., & Ellis, M. J. (2013). Renal transplant imaging using magnetic resonance angiography with a nonnephrotoxic contrast agent. Transplantation, 96(1), 91–96. https://doi.org/10.1097/TP.0b013e318295464c
Bashir, Mustafa R., Tracy A. Jaffe, Todd V. Brennan, Uptal D. Patel, and Matthew J. Ellis. “Renal transplant imaging using magnetic resonance angiography with a nonnephrotoxic contrast agent.Transplantation 96, no. 1 (July 15, 2013): 91–96. https://doi.org/10.1097/TP.0b013e318295464c.
Bashir MR, Jaffe TA, Brennan TV, Patel UD, Ellis MJ. Renal transplant imaging using magnetic resonance angiography with a nonnephrotoxic contrast agent. Transplantation. 2013 Jul 15;96(1):91–6.
Bashir, Mustafa R., et al. “Renal transplant imaging using magnetic resonance angiography with a nonnephrotoxic contrast agent.Transplantation, vol. 96, no. 1, July 2013, pp. 91–96. Pubmed, doi:10.1097/TP.0b013e318295464c.
Bashir MR, Jaffe TA, Brennan TV, Patel UD, Ellis MJ. Renal transplant imaging using magnetic resonance angiography with a nonnephrotoxic contrast agent. Transplantation. 2013 Jul 15;96(1):91–96.

Published In

Transplantation

DOI

EISSN

1534-6080

Publication Date

July 15, 2013

Volume

96

Issue

1

Start / End Page

91 / 96

Location

United States

Related Subject Headings

  • Vascular Patency
  • Surgery
  • Retrospective Studies
  • Primary Graft Dysfunction
  • Postoperative Complications
  • Middle Aged
  • Male
  • Magnetic Resonance Angiography
  • Kidney Transplantation
  • Kidney