Fractional mean transit time in transplanted kidneys studied by technetium-99m-DTPA: comparison of clinical and biopsy findings.
To determine the usefulness of fractional mean transit time (MTT) in the differential diagnosis of postrenal transplant complications, 99mTc-DTPA was used to evaluate differences in MTT between the outer zone (cortical nephron) and middle zone (juxtamedullary nephron, calcyces and cortical nephron) of the kidney. It is well known that acute rejection is characterized by delayed cortical transit time, whereas cortical nephron function is well maintained and juxtamedullary function is impaired after renal ischemia.


METHODS
Technetium-99m-DTPA fractional MTT was determined by deconvolution analysis of 89 renograms obtained within 5 days of the date of kidney graft biopsy and evaluation.


RESULTS
Outer zone MTT was significantly shorter than middle zone MTT in normals (2.7 +/- 0.4 versus 3.0 +/- 0.6 min, n = 22, p < 0.001), acute tubular necrosis (3.4 +/- 1.1 versus 3.6 +/- 1.4 min, n = 19, p < 0.01), chronic rejection (3.9 +/- 1.5 versus 5.0 +/- 2.3 min, n = 14, p < 0.001) and obstruction (4.1 +/- 0.6 versus 8.9 +/- 3.4 min, n = 13, p < 0.001). In contrast, outer zone MTT was significantly longer than middle zone MTT in acute rejection (4.8 +/- 3.2 versus 4.2 +/- 2.5 min, n = 21, p < 0.05).


CONCLUSIONS
Fractional MTT was demonstrated to be useful in differentiating acute rejection and ATN in transplanted kidneys.
Mizuiri
S
S
Department of Nephrology, Toho University, Tokyo, Japan.
Hayashi
I
I
Takano
M
M
Ban
R
R
Ohara
T
T
Sasaki
Y
Y
Hasegawa
A
A
D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D016030:Kidney Transplantation; D007683:Kidney Tubular Necrosis, Acute / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011866:Radioisotope Renography; D012079:Renal Circulation; D016284:Technetium Tc 99m Pentetate
D016284:Technetium Tc 99m Pentetate