COMPARISON OF EARLY POSTOPERATIVE FUNCTION OF LIVER AND RENAL ALLOGRAFTS WITH RADIONUCLIDE IMAGING

Abstract

P539 Aims: Radionuclide imaging is a valuable tool during the early posttransplantation period for the evaluation of the functional status of the renal and liver allografts. In addition to providing information related to posttransplantation complications, it has been reported to ensure prognostic information as well. The aim of this study was to compare the early postoperative functional course of renal and liver allografts with serial radionuclide imaging. Methods: Fifteen renal and 15 liver allograft recipients have been evaluated with serial radionuclide imaging. All grafts were from a living-related donor. For renal scintigraphy, every recipient was injected with Tc-99m DTPA and imaging has been 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. Region of interests have been drawn over the graft and the background (for hepatobiliary scintigraphy, the left ventricle and for renal scintigraphy, perirenal region was chosen). After generation of background-corrected time-activity curves, the following parameters were computed for each scintigraphy : Uptake (the ratio of maximum counts on the graft to that of background counts), time to excretion of radiopharmaceutical from the graft parenchyma and parenchymal retention at the end of the study. Results: Among 15 renal transplant recipients, 12 had normal uptake and Tex values on day 7 posttransplantation (80%). Eight renal grafts exhibited parenchymal retention (53%). Among 15 liver transplant recipients, 7 had normal uptake on first hepatobiliary scan (47%). All except 4 liver grafts had delayed excretion (73%) and 12 had parenchymal retention (80%) on the first scan with improvement of function observed on serial scintigraphies obtained during follow-up. Conclusions: The results indicate that renal transplant recipients are more likely to have a normal scintigraphy early post-transplantation compared to liver allograft recipients. This may be explained by the intensity of immune reaction in different organ grafts. Parenchymal retention was the most frequently observed functional abnormality for both renal and liver allografts. Most liver transplant recipients exhibit a delay in excretion and parenchymal retention on the first evaluation, with improvement on serial scintigraphy studies.