Nathan Artz, Presenter: Nothing to Disclose

Elizabeth A. Sadowski MD, Abstract Co-Author: Nothing to Disclose

Andrew Louis Wentland BS, Abstract Co-Author: Nothing to Disclose

David Niles, Abstract Co-Author: Nothing to Disclose

Yin Huang, Abstract Co-Author: Nothing to Disclose

Karl Vigen PhD, Abstract Co-Author: Nothing to Disclose

Thomas Martin Grist MD, Abstract Co-Author: Speaker, General Electric Company Advisory Board, Bayer AG Consultant, Bracco Group Speaker, Bracco Group

Arjang Djamali MD, Abstract Co-Author: Nothing to Disclose

Sean B. Fain PhD, Abstract Co-Author: Research grant, General Electric Company Research Consultant, Marvel Medtech, LLC

Kidney transplantation is the treatment of choice for end stage renal disease. Monitoring patients post-transplantation for changes in renal function safely and non-invasively is important in prolonging allograft function. This study measures and compares renal perfusion using a non-contrast MR perfusion technique in donor-recipient pairs before and after transplantation.

Six donor-recipient pairs were recruited for this IRB approved HIPPA compliant study. After consent was obtained, arterial spin labeling (ASL) MR exams were performed in the donor kidney one day prior to transplantation. Three months post-op, ASL-MR scans were repeated on the donor’s remaining right kidney and the recipient’s genetically identical transplanted kidney. ASL perfusion images were acquired on a 1.5 T MR system using a FAIR-bSSFP technique. Data was analyzed in MATLAB, using a custom written script, assuming a one compartment model. ASL perfusion measurements were averaged across cortical and medullary pixels separately for each kidney. A Wilcoxon signed-rank test was used to determine differences in perfusion (p<0.05).

For the transplanted kidneys measured 3 months after transplantation, average cortical perfusion decreased from 381 ml/min/100g before transplantation to 327 ml/min/100g (p<0.03). No difference in average cortical perfusion was measured in the doner’s remaining kidneys over the same period (381 to 388 ml/min/100g, p = 0.84). Medullary perfusion measurements did not change in either the transplanted kidneys (67 to 67 ml/min/100g, p=1.0) or the donor’s remaining kidneys (85 to 64 ml/min/100g, p = 0.56).

The average cortical perfusion of the donated kidneys decreased significantly after transplantation, possibly due to loss of function or use of anti-rejection medications in the recipient. Longitudinal studies over the next three years will monitor kidney perfusion in these donor-recipient pairs relative to biopsy and other markers of viability.

Documenting renal perfusion in donor-recipient pairs during and after transplantation provides a baseline physiologic range which may be used in future studies of renal pathophysiology.

Artz, N, Sadowski, E, Wentland, A, Niles, D, Huang, Y, Vigen, K, Grist, T, Djamali, A, Fain, S, Renal Perfusion Measured with ASL MRI in Donor-Recipient Pairs before and after Transplant.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9007040.html