Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Mar 18, 2024; 14(1): 89255
Published online Mar 18, 2024. doi: 10.5500/wjt.v14.i1.89255
Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction
Ameet Kumar Jesrani, Syed M Faiq, Rahma Rashid, Tariq Ali Kalwar, Rehan Mohsin, Tahir Aziz, Nida Amin Khan, Muhammed Mubarak
Ameet Kumar Jesrani, Syed M Faiq, Nida Amin Khan, Department of Radiology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Rahma Rashid, Muhammed Mubarak, Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Tariq Ali Kalwar, Tahir Aziz, Department of Transplantation, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Rehan Mohsin, Department of Urology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Author contributions: Jesrani AK, Faiq SM, Rashid R, Kalwar TA, Mohsin R, Aziz T, Khan NA, and Mubarak M, all eight authors contributed significantly and equally to the preparation of the manuscript; Jesrani AK and Kalwar TA conceived and designed the study; Jesrani AK, Kalwar TA, Khan NA, and Faiq SM performed the research; All eight participated in primary and final drafting; Mubarak M critically reviewed and finalized the draft; All read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Sindh Institute of Urology and Transplantation Institutional Review Board, No. 387.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data is available with the first author of the study and can be shared on reasonable request at drmubaraksiut@yahoo.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Muhammed Mubarak, MD, Professor, Department of Pathology, Sindh Institute of Urology and Transplantation, Chand Bibi Road, DFMC, Karachi 74200, Sindh, Pakistan. drmubaraksiut@yahoo.com
Received: October 25, 2023
Peer-review started: October 25, 2023
First decision: January 12, 2024
Revised: January 18, 2024
Accepted: February 27, 2024
Article in press: February 27, 2024
Published online: March 18, 2024
ARTICLE HIGHLIGHTS
Research background

Kidney transplantation is the treatment of choice for patients with end-stage kidney disease. Although, short-term outcomes have improved but long-term graft survival remains a formidable challenge. Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term survival. Conventional and novel ultrasound (US)-based investigations are being increasingly used for this purpose with variable results. This study aims to compare the diagnostic performance of two US-based tests with biopsy results.

Research motivation

The main aim is to determine the diagnostic performance of a non-invasive US-based investigation in the assessment of early chronic changes in the kidney allograft. This will help avoid or minimize the invasive procedure of kidney allograft biopsy.

Research objectives

The main objective was to assess the diagnositc performance of shear-wave elastography (SWE) on US of the allograft kidney for detection of early chronic changes in the kidney allograft. It was found that SWE performs better than resistive index (RI) and this can be a useful addition to the diagnostic armamenterium for post-transplant follow-up.

Research methods

All consecutive kidney transplant patients with increased serum creatinine levels and reduced glomerular filtration rate three months after transplantation were assessed by SWE and RI tools and the findings of these were analyzed against the kidney allograft biopsy results to determine their diagnostic performance.

Research results

The sensitivity, specificity, positive predictive value, and negative predictive value of SWE for the detection of chronic allograft damage were better as compared to RI results. These results indicate that SWE test is more sensitive for the detection of early chronic changes in the kidney allograft and this should be routinely used in the assessment of kidney allograft during post-transplant follow-up.

Research conclusions

Novel US-based techniques offer promising new tools for non-invasive monitoring of early chronic kidney allograft damage. These can be used for screening the kidney transplant patients during routine follow-up visits followed by biopsies.

Research perspectives

Further improvements in US-based techniques for non-invasive monitoring of kidney allograft status are needed.