99m Tc DTPA scan as a diagnostic marker of acute rejection in renal transplantation.
Forty renal transplant recipients were subjected to 99m Technicium Diethylene triamine pentacetic acid (DTPA)scans at regular intervals & whenever there was suspection of rejection. Serial scans of a group of 15 recipients from immediate post transplant period till withdrawal of cyclosporine were analysed separately & the results compared to with single scan analysis. The sensitivity & specificity of DTPA scan in the absence of acute tubular necrosis (ATN) was 94.1% & 87.5%, while the positive & negative predictive values were 88.8 & 93.3% respectively. Sensitivity & specificity of serial scan analysis (88.8% and 75%) in early post transplant period was higher than that of interpretation of single scan (75% & 66%). Serial scan changes predated clinical rejection during cyclosporine withdrawal period. We conclude that DTPA scan is both a sensitive & specific non-invasive diagnostic marker of acute rejection in absence of ATN & serial scans during early post transplant period & at the time of cyclosporine withdrawal are helpful in detecting the rejection accurately & at the earliest.
Kohli
H S
HS
Department of Nephrology, Urology & Nuclear Medicine, Sanjay Gandhi Post Graduate Institute of Medical Science, Lucknow, (U.P.), India.
Gupta
A
A
Arora
P
P
Mishra
V K
VK
Kher
V
V
Bhandari
M
M
Ghambir
S
S
Kumar
A
A
Sharma
R K
RK
Das
B K
BK
D000328:Adult; D016572:Cyclosporine / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000000981:diagnostic imaging* / Q000188:drug therapy; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D007683:Kidney Tubular Necrosis, Acute / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D016284:Technetium Tc 99m Pentetate
D016572:Cyclosporine; D016284:Technetium Tc 99m Pentetate