Tc-NGA imaging in liver transplantation: preliminary clinical experience.
Technetium-99m galactosyl-neoglycoalbumin (Tc-NGA) is a new liver imaging agent that binds to hepatic-binding protein, a hepatocyte-specific membrane receptor. The purpose of this study was to determine the potential of Tc-NGA imaging in clinical liver transplantation. A total of 25 studies were performed in nine patients. Imaging studies performed in the early posttransplant period in patients with good hepatic allograft function revealed diffuse patchiness in tracer distribution, a manifestation of preservation damage. Left lobar infarction was demonstrated within a few hours of ischemic injury. Right posterior segmental infarction was seen in another patient. Comparison of kinetic, clinical, and biochemical data revealed good correlation between hepatic allograft function and Tc-NGA kinetics. Major kinetic alterations were noted during periods of preservation injury, hepatic infarction, and acute rejection. These studies indicate: (1) major alterations in Tc-NGA kinetics occur during preservation injury, hepatic infarction, and acute rejection, and (2) Tc-NGA kinetic data appear to provide an accurate reflection of hepatic allograft function. Tc-NGA imaging has the advantages of being noninvasive and of utilizing standard nuclear medicine instrumentation, including portable imaging devices. In conclusion, Tc-NGA imaging provides a promising noninvasive approach for evaluation of liver function in patients undergoing hepatic transplantation.
Woodle
E S
ES
Department of Surgery, University of California, Davis Medical Center, Sacramento 95817.
Ward
R E
RE
Stadalnik
R C
RC
Vera
D R
DR
D000328:Adult; D000418:Albumins / Q000493:pharmacokinetics; D002648:Child; D006084:Graft Rejection; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging / Q000378:metabolism; D016031:Liver Transplantation; D009942:Organometallic Compounds / Q000493:pharmacokinetics; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D012709:Serum Albumin; D013667:Technetium / Q000493:pharmacokinetics; D014021:Tissue Preservation / Q000009:adverse effects
D000418:Albumins; D009942:Organometallic Compounds; D015609:Organotechnetium Compounds; D012709:Serum Albumin; C036586:technetium Tc 99m neogalactoalbumin; D013667:Technetium