Scintigraphic evaluation of paired renal allografts from the same cadaveric donor

Using Post Transplant 1 Week Tc-99m DPTA Renal Scan as Another Method for Predicting Renal Graft Failure

Purpose

The aims of this study were to determine whether post transplant renal scan performed at around 1 week can predict graft failure, and to identify the best predictive factors among easy-to-measure variables.

Materials and methods

We retrospectively evaluated patients who underwent Tc-99m DTPA renal scan at approximately 1 week after renal transplantation. They were separated into two categories at 3 months after the operation; graft failure and non-failure. Graft failure was confirmed by biopsy (rejection). Non-failure was confirmed either by biopsy or clinical follow-up with serum creatine (Cr). Scan parameters including glomerular filtration rate (GFR), Hilson perfusion index, peaks of the iliac and graft perfusion curves were analyzed. Clinical variables including age, sex, height, weight, systolic blood pressure, serum Cr, type of donated kidney, side of transplant, and immunosuppressant were also analyzed.

Results

Among total 45 patients, graft failure was present in 11 cases. The serum Cr level was significantly higher in the failure group. Among scan variables, only the GFR was significantly different between groups. GFR of <44.48 mL/min was predictive of graft failure (sen 88.9%). Serum Cr level >2.13 mg/dL was also predictive (sen 72.7%).

Conclusion

GFR on renal scan at approximately 1 week after kidney transplant can predict graft failure.