ACR Appropriateness Criteria® Renal Transplant Dysfunction: 2024 Update

Authors

Myles T. Taffel, New York University Langone Medical Center, New York, New York. Electronic address: Myles.Taffel@nyulangone.org.
Gaurav Khatri, Panel Chair, UT Southwestern Medical Center, Dallas, Texas.
Andrei S. Purysko, Panel Vice-Chair, Cleveland Clinic, Cleveland, Ohio.
Ryan Avery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Commission on Nuclear Medicine and Molecular Imaging.
Melanie P. Caserta, Mayo Clinic, Jacksonville, Florida.
Silvia D. Chang, University of British Columbia, Vancouver, British Columbia, Canada.
Alberto Diaz De Leon, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Dhakshinamoorthy Ganeshan, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Rajan T. Gupta, Duke University Medical Center, Durham, North Carolina.
Susie Q. Lew, George Washington University, Washington, District of Columbia; American Society of Nephrology.
Andrej Lyshchik, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Refky Nicola, SUNY Upstate Medical University, Syracuse, New York.
Carl Piel, UT Southwestern Medical Center, Dallas, Texas; American College of Emergency Physicians.
Alp Sener, Western University, London, Ontario, Canada; American Urological Association.
Andrew D. Smith, University of Alabama at Birmingham, Birmingham, Alabama.
Paul Nikolaidis, Specialty Chair, Northwestern University, Chicago, Illinois.

Document Type

Journal Article

Publication Date

5-1-2025

Journal

Journal of the American College of Radiology : JACR

Volume

22

Issue

5S

DOI

10.1016/j.jacr.2025.02.022

Keywords

AUC; Appropriateness Criteria; appropriate use criteria; kidney transplantation; renal transplant; renal transplantation; transplant dysfunction; transplant rejection

Abstract

Renal transplantation remains the treatment of choice in patients with end-stage renal disease as the 5-year survival rates for the graft in renal transplant patients range from 72% to 99%. Despite improvements in graft survival related to increased efficacy of immunosuppression drugs and improvements in surgical technique, various complications do occur. Ultrasound is the first-line imaging modality for the evaluation of renal transplants in the immediate postoperative period and for longitudinal follow-up. Various other imaging techniques serve as complementary examinations in specific clinical settings. Angiography remains the reference standard for arterial complications and is used for nonsurgical intervention, but noninvasive CT or MR angiography could be considered prior to an invasive procedure. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.

APA Citation

Taffel, Myles T.; Khatri, Gaurav; Purysko, Andrei S.; Avery, Ryan; Caserta, Melanie P.; Chang, Silvia D.; De Leon, Alberto Diaz; Ganeshan, Dhakshinamoorthy; Gupta, Rajan T.; Lew, Susie Q.; Lyshchik, Andrej; Nicola, Refky; Piel, Carl; Sener, Alp; Smith, Andrew D.; and Nikolaidis, Paul, "ACR Appropriateness Criteria® Renal Transplant Dysfunction: 2024 Update" (2025). GW Authored Works. Paper 7310.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/7310

Department

Medicine