Renal transplant

Dr Henry Knipe and Dr Ian Bickle et al.

Renal transplantation is one, if not the most, common transplant procedures undertaken worldwide. Consequently, purposeful and incidental imaging of renal transplants and renal transplant-related complications are increasingly common. These include acute renal transplant rejection and chronic renal transplant rejection. Both renal donors and recipients undergo a pre-operative workup. 

Most renal transplants are sited in the extraperitoneal right iliac fossa. For a variety of surgical reasons (including vessel suitability or previous failed renal transplants), they may occur in the left iliac fossa or elsewhere.  

  • renal transplant not often visualised directly as obscured by other soft tissues of the pelvis but may be visible if calcified (i.e. failed)
  • surgical paraphernalia such as clips and ureteric stents may be visible
  • complications related to underlying disease, or the renal transplant and its associated anti-rejection medications (e.g. osteonecrosis)

Renal transplant ultrasound is commonly utilised to evaluate for complications post-operatively. Read the separate article on this for US features 2.

The preoperative workup should include a chest and abdominal x-ray, an abdominal ultrasound, an echocardiogram and coronary stress tests. However, in most patients, an abdominal CT is also useful to evaluate arterial calcifications and calibre (especially of the right external iliac artery). 

Share article

Article information

rID: 44860
System: Urogenital
Section: Gamuts
Synonyms or Alternate Spellings:
  • Renal transplantation

Support Radiopaedia and see fewer ads

Cases and figures

  • Drag
    Case 1: on CT
    Drag here to reorder.
  • Drag
    Case 2: on radiograph
    Drag here to reorder.
  • Drag
    Case 3: retrograde pyelogram of a transplant
    Drag here to reorder.
  • Drag
    Case 4: with nephrostomy
    Drag here to reorder.
  • Drag
    Case 5: calcified transplants
    Drag here to reorder.
  • Drag
    Case 6: normal immediate post-op ultrasound
    Drag here to reorder.
  • Updating… Please wait.

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.