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Deconvolution Analysis of Renal Blood Flow: Evaluation of Postrenal Transplant Complications

Division of Nuclear Medicine, Department of Radiology and Department of Medicine, Faculty of Medicine, Chulalongkorn University Hospital, Bangkok, Thailand

Correspondence: For correspondence or reprints contact: Tawatchai Chaiwatanarat, Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University Hospital, Bangkok 10330, Thailand.

ABSTRACT

Medical complications after renal transplantation cause problems in treatment decision making. To differentiate acute tubular necrosis from acute rejection when it occurs in the early post-transplant period is difficult. Renal scintigraphy offers a noninvasive means for renal blood flow (RBF) and renal function assessment. Methods: This retrospective study of RBF and renal function evaluation after kidney transplantation is an attempt to calculate the "renal vascular transit time" from the ^99mTc-diethylenetriaminepentaacetic acid renal vascular flow with a deconvolution technique. The results of 102 studies on 38 graft recipients were evaluated. Of these, 19 were diagnosed as acute rejection, 12 as acute tubular necrosis, 4 as chronic rejection, 1 as vesicoureteric reflux, 1 as recurrent immunoglobulin A nephropathy, 1 as iliac vein thrombosis, 1 as cyclosporine nephrotoxicity and 63 as normal. All diagnoses were established by clinical and/or pathologic criteria. Results: With renal vascular transit times more than 12.8 sec, the sensitivity and specificity for the detection of acute rejection was 95% and 94%, respectively. The sensitivity and specificity for the differential diagnosis of acute rejection against acute tubular necrosis was 95% and 92%, respectively. Conclusion: The use of renal vascular transit time in addition to ¹³¹I-labeled hippuran renogram provides a promising diagnostic parameter to differentiate between acute rejection and acute tubular necrosis.

Key Words: radionuclide study • renal transplantation • renal vascular transit time • deconvolution

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