ArticleBlood purification2026
Point-of-Care Ultrasound in Post-Kidney Transplant Patients: Venous Excess Ultrasound Score and Lung Ultrasound for Fluid Assessment.
Article in Blood purification, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionAccurate volume assessment during the immediate post-kidney transplantation period reduces morbidity and mortality. Lung ultrasound (LUS), venous excess ultrasound score (VExUS), and bioimpedance analysis (BIA) are emerging methods for volume evaluation. We hypothesise LUS+VExUS may provide accurate means of congestion assessment in renal transplant patients, allowing more precise care.
methodAn exploratory, prospective, single-centre pilot study was conducted. A prospective cohort (Group 1, n = 31) underwent volume assessment using a combined VExUS + LUS protocol on days +1 and +7 post-transplantation, alongside physical examination (PhE) and BIA. Findings were compared with a historical reference cohort (Group 2, n = 40) managed with standard clinical assessment alone.
resultsGroups differed significantly in delayed graft function (45.2% vs. 15.0%, p = 0.008) and cold ischaemia time (p = 0.027). Acute pulmonary oedema occurred in 2/31 patients (6.5%) in Group 1 and 6/40 (15.0%) in Group 2, though this difference was not statistically significant (Fisher exact p = 0.452). VExUS showed no correlation with BIA (Spearman ρ = 0.127, p = 0.545), BNP (ρ = 0.187, p = 0.349), or Ca125 (ρ = 0.241, p = 0.226). VExUS detected venous congestion (grade ≥1) in 2/14 patients (14.3%) with normal PhE on Day +1. PhE showed poor agreement with VExUS (κ = 0.043) and moderate agreement with LUS (κ = 0.469). Combined ultrasound identified subclinical congestion in 28.6% of patients with normal PhE. Ultrasound findings prompted therapeutic modifications in 74.2% of cases on Day +1 (primarily IV fluid reduction) and 16.1% on Day +7.
conclusionIn this exploratory pilot study, VExUS and LUS provided additional diagnostic information beyond PhE and influenced clinical decision-making in the majority of cases. These hypothesis-generating findings warrant confirmation in larger, multicentre, prospective studies with standardised protocols.
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