Transplanted Kidney Function Evaluation
Section snippets
Renal Transplant Complications
There are various schemes used for the classification of renal transplant complications. The most commonly used ones either classify them as surgical vs medical or, depending on the localization of the underlying etiology, as prerenal, renal, and postrenal. Surgical complications comprise fluid collections, urinary obstruction, and vascular complications. Medical complications are related to parenchymal pathologies as acute tubular necrosis (ATN), acute rejection (AR), and drug toxicity.
From
Renal Function Tests
Renal transplant function is commonly monitored using serum creatinine level. Its production is dependent on age, gender, and muscle mass. Serum creatinine concentrations may remain within the reference range until approximately half of renal function has been lost. Plasma cystatin C level, 24-hour urinary output, and 24-hour creatinine clearance are among the measures used for the evaluation of renal function in transplant recipients. Creatinine reduction ratio and 24-hour urine creatinine
Radionuclide Imaging
Renal scintigraphy is a valuable approach to assess the 3 sequential phases of renal function. The first phase consists of the rapid dynamic imaging that is done during the first minute after tracer injection. This evaluates perfusion. The second phase is the period in which the nephrons extract the tracer from the blood and excrete it by glomerular filtration or tubular secretion or both. The third phase is the period during which the tracer drains through the pelvicalyceal system. The
Diagnosis of Early Posttransplantation Complications
A single study alone may prove to be diagnostic in cases of urinary leaks and renal artery thrombosis and may suggest the presence of several early parenchymal complications. Radionuclide imaging may be more helpful in isolated cases of ATN or AR. Initially accepted assumption of serial radionuclide imaging during the early posttransplantation period to be useful for a specific diagnosis is questionable. This necessitates the transport of patient to Nuclear Medicine Department several times
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Management of an aneurysmal arteriovenous fistula in kidney transplant recipients
2023, Transplantation ReviewsTwo point Dixon-based chemical exchange saturation transfer (CEST) MRI in renal transplant patients on 3 T
2022, Magnetic Resonance ImagingCitation Excerpt :For diagnosis of acute graft rejection, a percutaneous ultrasound-guided kidney biopsy has become a clinical standard method [6]. Nevertheless, because of the relatively low sensitivity of creatinine determinations and the invasiveness of renal biopsies, imaging modalities are increasingly used for monitoring renal transplant status [7]. A number of studies have demonstrated the efficacy of several functional renal MR imaging techniques for the evaluation of early and long term post-transplantation complications [8–11].
Gamma camera imaging of renal transplant
2022, Nuclear Medicine and Molecular Imaging: Volume 1-4Letter from the Editors
2021, Seminars in Nuclear MedicineInterleukin 8 Is Overexpressed in Acute Rejection in Kidney Transplant Patients
2020, Transplantation Proceedings<sup>99m</sup>Tc MAG3 scintigraphy in a patient with hyperacute antibody mediated Rejection: A description of the correlation between image findings and clinical disease process.
2019, Transplantation ReportsCitation Excerpt :Technetium-99m Mercaptoacetyltriglycine (99mTc MAG3) is presently the radiopharmaceutical of choice when evaluating renal transplants [5]. Renal scintigraphy with 99mTc MAG3 is an established functional imaging tool which provides useful information on renal graft function that cannot be obtained with other morphological imaging modalities [3]. In the literature the scintigraphic features of HA-AMR have not been described.