Effective renal plasma flow calculated from a single blood sample following Technetium-99m mercaptoacetyltriglycine renal scan can predict delayed graft function in renal transplantation.
OBJECTIVE
Effective renal plasma flow (ERPF) can be calculated by obtaining a single blood sample at a fixed time after injection in a patient undergoing a technetium-99m mercaptoacetyltriglycine (99mTc MAG3) renal scan. The purpose of this study was to determine whether the calculated ERPF following cadaveric renal transplantation could accurately predict the need fordialysis within the first 10 postoperative days or the serum creatinine at postoperative day 10.


METHODS
Between February 1994 and September 1998, 41 patients underwent 45 99mTc MAG3 renal scans within the first 10 days following a cadaveric renal transplantation at Harbor-UCLA Medical Center. A blood sample was drawn 44 minutes after injection of 99mTc and was used to calculate ERPF. This calculated ERPF was compared to measures of early function, such as the need for dialysis and serum creatinine.


RESULTS
Decreased ERPF strongly correlated with the need for dialysis within the first 10 postoperative days (p < .0001). No patient with ERPF >210 mL/min/1.7 M2 required dialysis, whereas 35% (6/17) of patients with ERPF < or =210 mL/min/1.7 M2 required dialysis within the first 10 postoperative days. For those patients who did not undergo dialysis, the calculated ERPF was significantly related to the serum creatinine on postoperative day 10 (p<.0001 ).


CONCLUSIONS
ERPF can be calculated from a single blood sample when performing a 99mTc MAG3 renal scan following cadaveric renal transplantation. This calculated ERPF provides a useful clinical tool to identify patients at high risk for development of delayed graft function.
Freedland
S J
SJ
Department of Urology, UCLA School of Medicine, Harbor- UCLA Medical Center, Los Angeles, California, USA.
Mishkin
F
F
Shoskes
D A
DA
D002102:Cadaver; D003404:Creatinine / Q000097:blood; D006084:Graft Rejection / Q000175:diagnosis*; D006801:Humans; D007668:Kidney / Q000098:blood supply; D016030:Kidney Transplantation / Q000000981:diagnostic imaging*; D011184:Postoperative Period; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000097:blood; D006435:Renal Dialysis / Q000706:statistics & numerical data; D017596:Renal Plasma Flow, Effective; D012680:Sensitivity and Specificity; D017263:Technetium Tc 99m Mertiatide / Q000097:blood; D013997:Time Factors
D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide; D003404:Creatinine