الفهرس 
AccknowlleedgeemeentOnly 14 pages are availabe for public view
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Abstract
These are very rewarding times in the field of renal transplantation. Advances in kidney procurement and preservation, better matching of donors and recipients, refined surgical techniques; availability of new, more effective immunosuppressive agents; and improved post transplant monitoring of kidney recipients have contributed to decreased patient morbidity and improved allograft survival. Doppler sonography is able to make a definitive diagnosis, so it is extremely useful as a screening tool in the management of renal transplant complications. All of this have allowed transplant patients greater opportunity to return to a more normal lifestyle after surgery.
Complications are numerous and varied include parenchymal insults i.e. (acute tubular necrosis, acute rejection and chronic rejection), vascular occlusion, obstruction, hemorrhage, urinary leak, collections, infection and drug toxicity.
Ultrasound is useful in its dual role of not only monitoring transplant dysfunction but also assessing response to therapy. Doppler sonography has been widely used in monitoring renal allograft over the past decade because of its non invasiveness, convenience and real time nature. Doppler sonography represents a useful diagnostic tool for detecting vascular complications of renal transplant such as AV fistulas and stenosis or thrombosis of renal vessels.
However, with respect to diagnosing pathologic conditions involving the small intrarenal vessels such as AR, CR & ATN, conventional Doppler sonography have limited success owing to its insensitivity in depicting blood flow in the microvascular bed. Power Doppler sonography is a more promising tool for depicting tissue perfusion of organs.
CONCLUSION
Ultrasound and Doppler examination of the transplanted kidney is one of the cornerstones in the diagnostic management of a failing renal graft. Diseases or complications in the vascular stalk can be diagnosed or excluded with high accuracy. The global circulation of the transplanted kidney can be assessed. Spectral Doppler with calculation of PI or RI can confirm significant pathology in the renal parenchyma, although the various causes may not be discerned. A complete evaluation using color or power Doppler with sensitive settings for flow detection in the parenchyma will pick up diffuse or localized perfusion abnormalities, as well as complications to intervention like AV fistulas and pseudoaneurysms. Thus, the ultrasound and various Doppler techniques play a major role in the follow up of the transplanted kidney.