title: Use of early postoperative MAG3 renal scan to predict long-term outcomes of renal transplants.
abstract: OBJECTIVE
  A Tc-99m mercaptoacetyltriglycine renal scan has been used to evaluate perfusion and excretory function of renal allografts. A Tc-99m mercaptoacetyltriglycine renal scan has been reported to correlate with early allograft outcomes. This study was done to determine whether a Tc-99m mercaptoacetyltriglycine renal scan has any relation with long-term renal transplant outcomes.
  
  
  METHODS
  A total of 311 consecutive kidney transplant recipients were included in the study. All had Tc-99m mercaptoacetyltriglycine renal scans on posttransplant days 3 and 7. Patterns of the renography curve was graded as follows: 0=normal perfusion and excretion; 1=normal perfusion, reduced excretion; 2=normal perfusion, flat excretion; and 3=reduced perfusion and rising curve. Early postoperative Tc-99m mercaptoacetyltriglycine scintigraphy findings were correlated with serum creatinine values, acute rejection episodes, and long-term graft survival.
  
  
  RESULTS
  A Tc-99m mercaptoacetyltriglycine renography of a deceased-donor kidney transplant showed a significantly higher grade on both days 3 and 7 than did live-donor kidney transplant (P < .001). Serum creatinine was positively correlated with the renography grades on days 3 and 7. The acute rejection rate was higher in the renography on days 3 and 7. Grade 2 renography on day 3 showed a significantly higher graft failure rate compared with the other grades (8.8% vs 8.6% vs 31.6% vs 7.3%; P = .014). Also, the renography showed the worst 5-year graft survival rate (95.9% vs 93.3% vs 89.5% vs 94.1%; P = .019). There were no differences in the graft failure rate or in graft survival rate according to the Tc-99m mercaptoacetyltriglycine renography grades on day 7.
  
  
  CONCLUSIONS
  Our data show that a Tc-99m mercaptoacetyltriglycine renography grade correlate not only with early postoperative kidney function and incidence of acute rejection, but also with long-term outcomes of a renal allograft. A grade 2 renography pattern, with normal uptake and flat excretion, indicates a dismal prognosis for the long-term allograft survival.
authors.affiliation: Department of Transplant and Vascular Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Ui-Jun
authors.initials: UJ
authors.lastname: Park
authors.forename: Hyoung-Tae
authors.initials: HT
authors.lastname: Kim
authors.forename: Won-Hyun
authors.initials: WH
authors.lastname: Cho
authors.forename: Min-Young
authors.initials: MY
authors.lastname: Kim
authors.forename: Eun-Ah
authors.initials: EA
authors.lastname: Hwang
authors.forename: Seung-Yeup
authors.initials: SY
authors.lastname: Han
authors.forename: Sung-Bae
authors.initials: SB
authors.lastname: Park
authors.forename: Hyun-Chul
authors.initials: HC
authors.lastname: Kim
authors.forename: Seok-Kil
authors.initials: SK
authors.lastname: Zeon
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D006084:Graft Rejection / Q000000981:diagnostic imaging*; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D017263:Technetium Tc 99m Mertiatide; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide