Renal Transplant Complications: Spectrum of Imaging Features on CT– A Retrospective Descriptive Study

A BSTRACT Background and Aim: Renal transplantation is the treatment of choice for end-stage renal disease, with improving results over the past decade. Although postoperative complications have reduced, they remain significant causes of morbidity and mortality in these cases. The aim of this study was to analyze various imaging findings and complications in post-renal transplant patients using computed tomography (CT) for early diagnosis and intervention. Method: One hundred and forty non-repetitive renal transplant cases that were referred for CT to investigate complications were retrospectively included in the study. The spectrum of imaging features was studied and analyzed. Result: The most common complication in the study was the presence of intra-abdominal collections, which affected 20 patients (28%), followed by graft pyelonephritis, observed in 19 patients (26.7%). Intra-abdominal/perinephric hematoma was seen in 10 patients (14%). Pseudoaneurysms and non-excreting/poorly excreting transplant kidneys were seen in five patients each (7% each). Three patients (4.2%) had venous thrombosis. Hydronephrosis, ureteric dehiscence with urine leak, and segmental infarcts in transplant kidneys were seen in two patients each (2.8% each). One patient had stenosis of the graft ureter, and one patient was found to have a metastatic adenocarcinoma deposit in the graft kidney. Conclusion: Complications in post-renal transplant patients can lead to graft loss, morbidity, and mortality if they are not promptly diagnosed and treated early. Hence, knowledge of these complications and their imaging appearances plays a vital role in the early management of these cases.