David Niles, Presenter: Nothing to Disclose

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

Nathan Artz, Abstract Co-Author: Nothing to Disclose

Andrew Louis Wentland BS, 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

Yin Huang, Abstract Co-Author: Nothing to Disclose

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 is important in prolonging the life of an allograft. Blood oxygenation level dependent (BOLD) MRI is a noninvasive tool capable of evaluating oxygen bioavailability and providing insight into kidney physiology. Previous studies have demonstrated changes in oxygen bioavailability between transplanted kidneys with acute rejection and allografts with normal function. Using donor-recipient pairs, this study aims to understand the normal physiologic response in kidneys undergoing transplantation compared to the genetically identical kidney remaining in the donor.

Five donor-recipient pairs were recruited for this IRB-approved HIPAA compliant study. After consent was obtained, BOLD MRI was performed in the donor one day prior to transplantation. Three months following surgery, BOLD MRI scans were performed on the donor’s remaining right kidney and the recipient’s transplanted kidney. BOLD MR images were acquired on a 1.5 T MR system using a multiple gradient echo sequence with a water-selective excitation pulse. Data were analyzed using the manufacturer's post-processing tools. R2* measurements were taken as an average for multiple ROIs placed in the cortex and medulla. A Wilcoxon signed-rank test was used to determine any significant differences in R2* (p<0.05).

At 3 months post-transplantation there were no significant changes in the cortical or medullary R2* values for kidneys which were donated (Cortex = 12.2/s to 11.6/s, p = 0.25; Medulla = 19.4/s to 18.3/s, p = 0.125). Similarly, at 3 months post-transplantation there were no significant changes in cortical or medullary R2* for the kidneys remaining in the donors (Cortex = 12.0/s to 11.6/s, p = 0.75; Medulla = 19.1/s to 18.4/s, p = 0.375).

The oxygenation gradients appear to be maintained in both the donor’s remaining kidney as well as the kidney transplanted to the recipient. Future studies over the next three years will monitor kidney oxygen bioavailability in a larger cohort of donor-recipient pairs in order to document baseline parameters for normal transplanted kidney physiology.

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

Niles, D, Sadowski, E, Artz, N, Wentland, A, Grist, T, Huang, Y, Djamali, A, Fain, S, BOLD MRI Measurements Pre-transplantation and 3 Months Post-transplantation in Donor-Recipient Pairs.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9011594.html