ANALYSIS OF THE ARTERIAL BLOOD-FLOW PATTERNS OF NORMAL AND ALLOGRAFTED KIDNEYS BY THE DIRECTIONAL ULTRASONIC DOPPLER TECHNIQUE

The arterial blood flow of the allotransplanted kidney was examined 52 times in 40 recipients and that of the normal kidney 6 times in 6 donors by means of the directional ultrasonic Doppler technique. The blood flow patterns showed a rapid forward phase in systole and a slow forward phase in diastole but nothing indicative of a reverse flow was found. A significant correlation was observed between the acceleration time of flow component and graft function, while there were no correlations among diastole/systole ratio, appearance time and graft function. The arterial blood flow patterns of the grafts were classified into 3 groups based on acceleration time: I-excellent, II-intermediate and III-poor graft functions. To study possible relationships between the ultrasonic Doppler flow patterns of the grafts and their morphological features, histopathology and angiography were done for 20 and 15 recipients, respectively. The histologic vascular changes with interstitial damage were responsible for the angiographic findings, such as sparse arborization, beading and blocking of the peripheral vasculature. Changes in Doppler flow pattern were secondary to the morphological changes of the allografts induced mainly by rejection.