Introduction: Allograft doppler ultrasonography is a readily available diagnostic tool to evaluate the renal allograft.  Its benefit in evaluating a clinically unremarkable allograft is not well established.
Objectives: The primary objective of this study was to determine which doppler ultrasound parameters will correlate with early graft dysfunction.
Methods: A retrospective chart review of patients who underwent kidney transplantation between January 2017 to December 2021 done at the National Kidney and Transplant Institute, and had a baseline post-operative renal allograft doppler ultrasound were included.  
Results: 450 patients were included.  67 developed early graft dysfunction. Among the doppler ultrasound parameters analyzed, pulsatility index, with a cut-off of ≥ 1.95, revealed a sensitivity of 60.61% and specificity of 71.96%.  The receiver operating characteristic area for the pulsatility index was 0.71, indicating a good discriminatory capacity.  Peak systolic velocity, using a cut-off of ≤ 73.95, manifested a sensitivity of 54.55% and specificity of 61.42%. Its ROC area of 0.56 suggests moderate discriminating power. Overall, the pulsatility index appears to be a stronger diagnostic tool for early graft dysfunction. 


Conclusion: A baseline doppler ultrasound done post-transplantation is a helpful diagnostic tool.  An elevated pulsatility index correlates well in predicting early graft dysfunction.  A larger prospective study will need to be performed before its routine use can be recommended.