КОРРЕЛЯЦІЯ УЛЬТРАЗВУКОВИХ МОРФОМЕТРИЧНИХ ПАРАМЕТРІВ З МОРФОЛОГІЧНИМИ ЗМІНАМИ НИРКОВИХ АЛОТРАНСПЛАНТАТІВ У РЕЦИПІЄНТІВ ПІСЛЯ ТРАНСПЛАНТАЦІЇ НИРКИ

Early detection of structural and functional impairment in renal allografts is a key challenge in contemporary transplantology. Although morphological verification offers substantial diagnostic value, biopsy is invasive and unsuitable for routine dynamic monitoring. Objective. To assess the relationship between ultrasound morphometric parameters of the renal allograft and its morphological changes in kidney transplant recipients. Materials and methods. A prospective cohort study was conducted involving 72 recipients: MFC-1 (n=41, optimal graft function) and MFC-2 (n=31, suboptimal graft function). Comprehensive clinical-laboratory, immunological, ultrasound, and morphological examinations were performed, with morphological findings assessed according to the Banff classification. Statistical significance threshold−p < 0.05. The study was conducted in accordance with the principles of the Declaration of Helsinki of the World Medical Association (2013 revision). The study protocol was approved by the Local Ethics Committee of Samarkand State Medical University (Protocol No. 12, 2020). Written informed consent was obtained from all participants. Quantitative variables are presented as mean ± standard deviation (M±SD). Intergroup differences were assessed using Student's t-test (for normally distributed data) and the Mann–Whitney U test (for data not conforming to a normal distribution). Correlation analysis (Pearson's or Spearman's coefficient, depending on the type of data distribution) was used to assess the relationship between ultrasound morphometric parameters and morphological graft changes. Statistical significance threshold — p<0.05. Statistical processing was performed using SPSS Statistics v.26.0. This study was conducted as part of the research plan of the Samarkand Regional Multidisciplinary Medical Centre Improving methods for early diagnosis and monitoring of renal allograft function (2020–2025). Results. MFC-2 patients showed more pronounced ultrasound morphometric abnormalities: a higher baseline resistive index (0.78±0.01 versus 0.74±0.01) and lower venous flow (12.8±0.5 versus 15.0±0.5 mL/s). The i0/t0/v0 profile was recorded in only 40.0% of biopsies in the MFC-2 group compared with 65.8% in the MFC-1 group. Statistically significant correlations were found between the leukocytic intoxication index and the resistive index (r=+0.68; p<0.01). Morphological assessment according to the Banff classification revealed more pronounced injury in the MFC-2 group: the i1/t1/v0 profile was recorded in 37.8% of biopsies (versus 21.9% in MFC-1), and the i2/t2/v1 profile (moderate arteritis, marked tubulitis) in 22.2% (versus 4.8% in MFC-1). Severe inflammatory changes (i2/t2/v2) were not recorded in either group. Additional statistically significant correlations were established: between the leukocytic intoxication index and venous flow (r=−0.61; p<0.05), between the degree of Banff tubulitis and creatinine level (r=+0.71; p<0.01), and between the resistive index and the degree of Banff vasculitis (r=+0.65; p<0.05). In patients with arteritis (v1 and above), the resistive index exceeded 0.75, whereas in the absence of vasculitis (v0) it remained within the range of 0.65–0.70 (p<0.05). Conclusions. Ultrasound morphometric parameters of the renal allograft have diagnostic value and correlate with morphological changes according to Banff criteria. Their comprehensive interpretation, together with laboratory and immunological data, facilitates early detection of structural impairment and optimizes patient selection for biopsy.