Abstract
Background: Assessment of morphology of transplanted kidneys provides informative data on underlying pathological processes that involve the transplanted kidneys. Identification of these morphologic changes is useful to predict the rejection as early as possible. Objective: to evaluate the morphologic changes like corticomedullary differentiation, corticomedullary ratio, cortical thickness, size of transplanted kidneys with correlation with duration of the graft in Sudanese patients. Methodology: This retrospective study was conducted in Khartoum State from July 2015 to April 2017. A total of 115 cases of transplanted kidneys were analyzed. A designed data collection sheet was used to collect the sonographic findings, clinical and demographic data. The renal cortex, corticomedullary differentiation and ratio (CMD & CMR) and graft size were evaluated.
Results: The incidence of renal transplantation was higher in males than females (89 vs. 26) and most common in the age of 20 to 49 years old. Sonographic evaluation of transplanted kidneys revealed that the CMD was disturbed in 20.9% (24 cases) lost in 6.96%(8 cases) and preserved in 72.2% (83 cases). The CMR was increased by 8 (6.98%) and decreased by 15.65% (21 cases). The cortical thickness was thin in 9.6%(11 cases), thick in 2.6%(3 cases) and normal in 87.8% (101 cases). The size of the graft was significantly decreased with duration of the transplantation (p-value =0.008). Conclusion: In Sudanese patients, considerable morphologic changes involving the renal graft in the duration ranged between 2 to 30 months. The incidence of morphologic changes increased as the age of transplantation increased. The graft size is the most significant morphologic change occurred as age of transplantation advanced. The ultrasound evaluation of renal grafts should be performed periodically to predict graft dysfunction.
Key words: Sonographic, graft, morphologic changes, transplanted kidneys, cortico-medullary differentiation.