Renal allograft accumulation of technetium-99m sulfur colloid as a predictor of graft rejection.
Differentiation between rejection (the most common cause) and many other possibilities for detrimental effects on graft function represents a difficult issue to diagnose the cause of renal allograft dysfunction. This study was designed to determine whether technetium-99m sulfur colloid (TSC) accumulation predicted graft rejection. We prospectively studied 54 episodes of allograft dysfunction in 53 kidney transplant recipients who underwent TSC scintiscanning and graft biopsy. Visual analysis of TSC uptake compared uptake, in the allograft with that in the marrow of the fifth lumbar vertebra (L5). A 3+ result meant that allograft uptake was greater than L5 marrow uptake; 2+, the same; 1+, less and finally 0, no allograft uptake. Transplant accumulation of 2+ or more was considered consistent with rejection (P = .01). Allograft biopsies interpreted based on the Banff Working Classification showed rejection in 45 of 54 renal biopsies with 42 the biopsy-proven rejection episodes showing at least 2+ graft uptake. Furthermore, this nuclear medicine technique had a sensitivity of 93.3%, a specificity of 44.4%, a positive predictive value of 89.3%, a negative value of 57.1% and an efficiency of 83.3% for the diagnosis of renal allograft rejection.
Einollahi
B
B
Kidney Transplant Department, Baqiyatallah University of Medical Sciences and Urology/Nephrology Research Center (UNRC), Tehran, Iran. einollahib@yahoo.com
Bakhtiari
P
P
Simforoosh
N
N
Amirjalali
R
R
Bassiri
A
A
Nafar
M
M
Pour-Reza-Gholi
F
F
Firouzan
A
A
Lessan-Pezeshki
M
M
Khatami
M R
MR
Nourbala
M H
MH
Pourfarzini
V
V
D000328:Adult; D001692:Biological Transport; D001853:Bone Marrow / Q000000981:diagnostic imaging; D005260:Female; D006084:Graft Rejection / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D016030:Kidney Transplantation / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D013671:Technetium Tc 99m Sulfur Colloid / Q000493:pharmacokinetics*; D014018:Tissue Distribution
D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid