Point-of-care-ultrasound for the assessment of post-renal transplant recipients

Authors

  • Michael Uy Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
  • Cameron Lam Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
  • Yanbo Guo Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
  • Rahul Bansal Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
  • Richard Hae Division of Nephrology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
  • Azim Gangji Division of Nephrology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
  • Christine Ribic Division of Nephrology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
  • Shahid Lambe Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.

DOI:

https://doi.org/10.5489/cuaj.8531

Keywords:

point-of-care ultrasound, POCUS, education, transplant

Abstract

INTRODUCTION: Postoperative imaging for deceased donor renal transplants is often delayed, as these surgeries occur after-hours. These delays can be critical in identifying immediate complications. To our knowledge, there are no formal training programs for point-of-care ultrasound (POCUS) in this setting; therefore, we aimed to develop and evaluate a feasible and practical POCUS curriculum for the assessment of a renal transplant graft.

METHODS: Urology and nephrology transplant physicians completed a three-hour online course, followed by a five-hour hands-on seminar for sonographic scanning. Simulated patients with transplanted kidneys were used. Course material was developed with licensed ultrasound technologists based on Sonography Canada national competency profiles. Pre- and post-course surveys focused on user confidence, while pre- and post-course multiple-choice questionnaires assessed theoretical knowledge.

RESULTS: Twelve participants were included, six of whom were urologists. Theoretical knowledge in POCUS improved significantly (p<0.001). Confidence in manipulation of ultrasound controls, Doppler imaging, and POCUS of the transplant kidney also improved (all p<0.001, d>2.0). Participants indicated an increased likelihood of POCUS use in clinical practice and that training should be integrated into a transplant fellowship.

CONCLUSIONS: We introduced a novel and guideline-based POCUS curriculum that leveraged local ultrasound educators and found improved theoretical knowledge and skill confidence in our cohort of transplant physicians. This course will serve as the first step toward a validated competency-based training system for POCUS use in the immediate post-renal transplant setting, and likely will be incorporated into the training of the modern transplant physician.

Downloads

Download data is not yet available.

Author Biographies

Michael Uy, Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada

 

 

Cameron Lam, Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada

 

 

Yanbo Guo, Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada

 

 

Rahul Bansal, Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.

 

 

Richard Hae, Division of Nephrology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

 

 

Azim Gangji, Division of Nephrology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

 

 

Christine Ribic, Division of Nephrology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

 

 

Shahid Lambe, Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.

 

 

Downloads

Published

2023-12-21

How to Cite

Uy, M., Lam, C., Guo, Y., Bansal, R., Hae, R., Gangji, A., Ribic, C., & Lambe, S. (2023). Point-of-care-ultrasound for the assessment of post-renal transplant recipients. Canadian Urological Association Journal, 18(4), 110–4. https://doi.org/10.5489/cuaj.8531

Issue

Vol. 18 No. 4 (2024): CUAJ April

Section

Original Research

License

You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:

  • Post the Article on any Web site
  • Translate or authorize a translation of the Article
  • Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so
  • Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.

The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.

You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.

The CUA also requires you to warrant the following:

  • That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;
  • That all individuals who have made a substantive contribution to the article are acknowledged;
  • That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and
  • That the Article does not libel or violate the privacy rights of any third party.