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Abstract: SA-PO1089

Kidney MR Elastography on Controls and Patients with Kidney Transplant

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Serai, Suraj D., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Otero, Hansel J., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Finn, Laura S., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Bhatti, Tricia, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Viteri, Bernarda, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
Background

To compare the diagnostic performance of MR elastography in controls and in pediatric patients with transplant kidneys.

Methods

A prospective study of pediatric kidney transplants undergoing clinically indicated biopsy & healthy controls, was performed. MRE was performed on a 3T MRI scanner equipped with MRE hardware consisting of an active-passive driver system. A 2D & 3D spin-echo planar MRE sequence were used to acquire coronal wave images and mean kidney stiffness (in kPa) were measured. For each patient, one to three needle biopsy cores of the lower pole were obtained and fixed in formalin. Three micron sections were stained with hematoxylin & eosin, and Masson trichrome. The severity of interstitial fibrosis and tubular atrophy (IFTA) was graded according to Banff 2017. A comparative analysis was performed using one-way ANOVA.

Results

A prototype hardware, software and acquisition sequence for Kidney MRE was developed and implemented. 10 pediatric controls were enrolled (Median age: 14.5 years). Mean kidney stiffness was 3.8 kPa. We also enrolled 4 healthy adults (Median age: 28 years). Mean stiffness measured by MRE was 4.2 kPa. Significantly higher mean baseline stiffness was observed in adult controls as compared to children. 12 kidney transplant recipients were enrolled (Median age: 15.5 years). Mean stiffness measured was 5.3 kPa. We found the mean stiffness of kidneys in children with allografts was significantly higher than controls. MRE showed significant differences among the allograft groups when evaluating IFTA.

Conclusion

Our study has shown that MRE has the potential to be utilized as non-invasive tools for quantitative measurement of fibrosis in renal allografts with a correlation with histopathology. MRE technology has the potential of detecting IFTA in patients with kidney transplant.

Funding

  • NIDDK Support