Published online Mar 18, 2024. doi: 10.5500/wjt.v14.i1.89255
Peer-review started: October 25, 2023
First decision: January 12, 2024
Revised: January 18, 2024
Accepted: February 27, 2024
Article in press: February 27, 2024
Published online: March 18, 2024
Processing time: 141 Days and 19.9 Hours
Kidney transplantation is the treatment of choice for patients with end-stage kidney disease. Although, short-term outcomes have improved but long-term graft survival remains a formidable challenge. Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term survival. Conventional and novel ultrasound (US)-based investigations are being increasingly used for this purpose with variable results. This study aims to compare the diagnostic performance of two US-based tests with biopsy results.
The main aim is to determine the diagnostic performance of a non-invasive US-based investigation in the assessment of early chronic changes in the kidney allograft. This will help avoid or minimize the invasive procedure of kidney allograft biopsy.
The main objective was to assess the diagnositc performance of shear-wave elastography (SWE) on US of the allograft kidney for detection of early chronic changes in the kidney allograft. It was found that SWE performs better than resistive index (RI) and this can be a useful addition to the diagnostic armamenterium for post-transplant follow-up.
All consecutive kidney transplant patients with increased serum creatinine levels and reduced glomerular filtration rate three months after transplantation were assessed by SWE and RI tools and the findings of these were analyzed against the kidney allograft biopsy results to determine their diagnostic performance.
The sensitivity, specificity, positive predictive value, and negative predictive value of SWE for the detection of chronic allograft damage were better as compared to RI results. These results indicate that SWE test is more sensitive for the detection of early chronic changes in the kidney allograft and this should be routinely used in the assessment of kidney allograft during post-transplant follow-up.
Novel US-based techniques offer promising new tools for non-invasive monitoring of early chronic kidney allograft damage. These can be used for screening the kidney transplant patients during routine follow-up visits followed by biopsies.
Further improvements in US-based techniques for non-invasive monitoring of kidney allograft status are needed.