Kidney Week

Abstract: SA-PO095

Multiparametric MRI Characteristics of the Renal Allograft in the Early Post-Transplant Period

Session Information

• Transplantation: Recipient and Donor Assessment
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Gillis, Keith, University of Glasgow, Glasgow, United Kingdom

Keith Gillis,

• Allwood-Spiers, Sarah, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom

Sarah Allwood-Spiers,

• Rankin, Alastair J., University of Glasgow, Glasgow, United Kingdom

Alastair J. Rankin,

• Roditi, Giles, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom

Giles Roditi,

• Radjenovic, Aleksandra, University of Glasgow, Glasgow, United Kingdom

Aleksandra Radjenovic,

• Patel, Rajan, University of Glasgow, Glasgow, United Kingdom

Rajan Patel,

• Mark, Patrick B., University of Glasgow, Glasgow, United Kingdom

Patrick B. Mark,

Group or Team Name

• Glasgow Renal Research Group

Background

Renal allograft function is currently measured using estimated glomerular filtration rate (eGFR) and proteinuria, however these do not provide comprehensive information regarding prognosis or presence of important pathological features such as fibrosis. Use of multi-parametric magnetic resonance imaging (MRI) may yield novel biomarkers for prediction of outcome and response to therapy in renal transplantation.

Methods

Patients undergoing renal transplantation underwent multi-parametric MRI at 6 weeks post operatively. Routine clinical and biochemical measures were made. MRI protocol entailed arterial spin labelling (ASL) perfusion, T1 relaxation time and R2*. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were measured, and tractography maps produced, by diffusion weighted imaging.

Results

20 patients were recruited with median age 55.5±12.8 years, eGFR of 51.8±27.4 ml/min/1.73m², and trough tacrolimus of 8.7±2.5 ng/mL. Cortical ASL was 283.0±116.2 ml/min/100g, ADC 1.69±0.11 x10^-3 mm²/s, FA 0.22±0.04, T1 was 1715±114 ms.
ADC had a significant correlation with eGFR (r=0.48, p=0.03), and a negative association with cold ischaemia time (r=-0.55, p=0.01) and recipient age (r=-0.45, p=0.04). There was also a negative correlation between recipient age and cortical ASL (r=-0.60, p=0.04), Differences in transplant function were visible on diffusion tensor imaging (figure 1).

Conclusion

Diffusion weighted imaging may provide a novel method of evaluating renal transplant structure and function. Further research is required to determine if this provides increased prognostic information additional to existing biochemical measures.