title: Relevance of Tc-99m DMSA scintigraphy in renal transplant parenchymal imaging.
abstract: Tc-99m DMSA renal scintigraphy was performed in 40 renal grafts. Cyclosporin A and glucocorticoids were given to all patients as antirejection therapy, and 11 also were given azathioprine. The kidneys were transplanted 1 to 97 months before the investigation. Seventy percent of kidneys had diffusely altered distribution of Tc-99m DMSA, and 43% had focal clear-cut parenchymal defects. The frequency of parenchymal defects observed on the DMSA scans was higher in patients who suffered manifest acute rejection episodes (8/16 versus 9/24 patients, borderline significance, P < 0.06), but had no relation to the living or cadaveric donor transplant or its function. A combination of peritubular edema and interstitial fibrosis is considered the most probable explanation of diffuse changes. The high frequency of clear-cut parenchymal defects most likely results from symptomatic or asymptomatic rejection episodes complicated by renal transplant infarcts.
authors.affiliation: Department of Nuclear Medicine, University Medical Centre, Ljubljana, Slovenia.
authors.forename: N V
authors.initials: NV
authors.lastname: Budihna
authors.forename: M
authors.initials: M
authors.lastname: Milcinski
authors.forename: M
authors.initials: M
authors.lastname: Kajtna-Koselj
authors.forename: M
authors.initials: M
authors.lastname: Malovrh
mesh_terms: D000208:Acute Disease; D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000627:therapeutic use; D004487:Edema / Q000378:metabolism; D005260:Female; D005355:Fibrosis; D005938:Glucocorticoids / Q000627:therapeutic use; D006084:Graft Rejection / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000517:prevention & control; D006801:Humans; D007238:Infarction / Q000378:metabolism; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000378:metabolism; D016030:Kidney Transplantation / Q000000981:diagnostic imaging* / Q000473:pathology; D007684:Kidney Tubules / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds / Q000493:pharmacokinetics; D011877:Radionuclide Imaging; D004113:Succimer / Q000493:pharmacokinetics; D019783:Technetium Tc 99m Dimercaptosuccinic Acid
chemical_list: D005938:Glucocorticoids; D015609:Organotechnetium Compounds; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D016572:Cyclosporine; D003404:Creatinine; D004113:Succimer; D001379:Azathioprine