Elsevier

Transplantation Proceedings

Volume 37, Issue 1, January–February 2005, Pages 355-358
Transplantation Proceedings

Comparison of early postoperative function of liver and renal allografts with radionuclide imaging

https://doi.org/10.1016/j.transproceed.2004.12.027Get rights and content

Abstract

Objectives

Radionuclide imaging is a valuable tool during the early posttransplantation period for evaluating the functional status of renal and liver allografts. The aim of this study was to compare the early postoperative function of renal and liver allografts with serial radionuclide imaging.

Methods

Twenty-two renal and 22 liver allograft recipients were evaluated with serial radionuclide imaging. All grafts were from living related donors. For renal scintigraphy, recipients were injected with Tc-99m DTPA, and imaging was performed on postoperative days 3 and 7. Liver allograft recipients were evaluated with Tc-99m mebrofenin hepatobiliary scintigraphy within the first postoperative week and as required thereafter. The following parameters were computed for each scintigraphy: uptake, time to excretion of the radiopharmaceutical (Tex), and retention of radioactivity at the end of the study.

Results

Among 22 renal transplant recipients, 19 (86%) had normal uptake and Tex values on day 7 posttransplantation. Nine (41%) renal grafts exhibited retention. Among 22 liver transplant recipients, 7 (32%) had normal findings on the first hepatobiliary scan. All except eight liver grafts (64%) had a delay in Tex, and 15 (68%) had parenchymal retention on the first scan, with improvement of function observed on serial scintigraphies obtained during follow-up. Decreases in uptake were seen less frequently and correlated with a prolonged postoperative hospital stay.

Conclusion

Renal transplant recipients are more likely than liver allograft recipients to have a normal scintigraphy in the early posttransplantation period. Retention of radioactivity at the end of the study was the most frequently observed abnormality for both renal and liver allografts. Most liver transplant recipients exhibited a delay in excretion, and parenchymal retention, of radioactivity on the first evaluation, with subsequent improvement on follow-up serial scintigraphy studies.

Section snippets

Methods

Twenty-two liver and 22 renal allograft recipients were included. All grafts were from living related donors. In all cases, there were at least two serial scintigraphic studies obtained during the early posttransplantation period. In the case of the liver, the first scan was obtained within 1 week after the operation and the second one was within the following 15 days. Forty-seven studies were evaluated. In the case of the kidney, radionuclide imaging was performed on postoperative days 3 and

Renal transplant recipients

In renal transplant recipients, mean serum creatinine levels 7 days after operation were significantly decreased compared with preoperative values, and all recipients were discharged within 10 days postsurgery.

On day 3 posttransplantation, all recipients had a normal time to excretion, and 19 (86%) had normal uptake. Nine (41%) had mild retention of radioactivity at the end of the study. On day 7 posttransplantation, all had normal Tex. Two patients with slightly diminished uptake on day 3 had

Discussion

Transplantation is the treatment of choice for patients with end-stage organ failure. Kidneys and livers are among the most commonly transplanted solid organs. There are many factors that influence postoperative hospital stay and recovery of transplanted organ function early after transplantation. Intraoperative factors that influence postoperative function in these two organ transplantations are similar. Ischemia-reperfusion injury just before or during transplantation is a common problem in

References (8)

  • Z. Ben-Ari et al.

    Intrahepatic cholestasis after liver transplantation

    Liver Transpl

    (2003)
  • M. Tulchinsky et al.

    Technetium-99m-MAG3 scintigraphy in acute renal failure after transplantation: a marker of viability and prognosis

    J Nucl Med

    (1997)
  • G.R. Stephenson et al.

    Malnutrition in liver transplant patients: preoperative subjective global assessment is predictive of outcome after liver transplantation

    Transplantation

    (2001)
  • H. Boom et al.

    Calcium levels as a risk factor for delayed graft function

    Transplantation

    (2004)
There are more references available in the full text version of this article.
View full text