A major reason for poor long-term kidney transplant outcomes is interstitial fibrosis. Currently, percutaneous biopsy, an invasive procedure that samples <1% of the allograft, is the gold standard for detecting renal allograft fibrosis. As the allograft scars, it stiffens due to the deposition of stiff extracellular matrix. This stiffening can be imaged non-invasively using magnetic resonance elastography (MRE). We used serial renal stiffness MRE imaging and serial percutaneous biopsies to measure whole allograft fibrosis preogression in a kidney transplant recipient. We show that renal allograft MRE can detect changes in overall fibrotic burden, as confirmed by biopsy.
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