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In 61 patients (167 examinations) the pulsatile flow index (PFI) was used to diagnose the cause of renal transplant dysfunction. The results were correlated with histology and clinical course and outcome, angiography or quantitative radionuclide renography. Renal transplant rejection was diagnosed by PFI with a sensitivity of 85%. The specificity was 81% and the diagnostic accuracy 83%. The positive predictive value was found to be 76%, whereas the negative predictive value was 89%. In presence of acute tubular necrosis (ATN) the PFI was normal in 89% of examinations and therefore distinguishable from acute rejection.
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