Correlation of radionuclide findings in renal transplants with interstitial cellular infiltrations
Allograft rejection is the most common cause of transplant dysfunction and loss. The differential diagnosis of acute cellular rejection (ACR) includes acute tubular necrosis (ATN) and cyclosoprin-A nephrotoxicity (Cs-A NT). Early, non-invasive differentiation is important due to differences in the management of these processes. Pathologically, a prominent mononuclear interstitial cell infiltrate (ICI) on biopsy in the usual diagnostic finding of ACR. The authors retrospectively evaluated serial radionuclide studies utilizing Tc-99m DTPA for renal perfusion and I-131 hippuran for renal tubular function in 35 renal transplant recipients. Of 24 cases of moderate to marked ICI involving 21 patients, matched serial radionuclide studies revealed strong evidence of ACR (deteriorating perfusion) in 18, questionable ACR in 3, chronic rejection in 3 and ATN in 1. Parametric analysis of the renal perfusion curve with respect to uptake and washout slopes and peak to plateau ratio has proved of considerable value in the evaluation. The authors conclude that only moderate to marked ICI appears to be correlated with radionuclide and clinical diagnoses of ACR. No or mild ICI may represent ATN, Cs-A-NT or ACR.
- Research Organization:
- Departments of Radiology, Pathology and Surgery, The Univ. of Texas Medical School, Houston, TX
- OSTI ID:
- 5939006
- Report Number(s):
- CONF-850611-
- Journal Information:
- J. Nucl. Med.; (United States), Journal Name: J. Nucl. Med.; (United States) Vol. 26:5; ISSN JNMEA
- Country of Publication:
- United States
- Language:
- English
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550901 -- Pathology-- Tracer Techniques
59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
AMINO ACIDS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
CARBOXYLIC ACIDS
CHELATING AGENTS
COUNTING TECHNIQUES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DIAGNOSTIC USES
DISTRIBUTION
DRUGS
DTPA
DYNAMIC FUNCTION STUDIES
EVALUATION
GRAFT-HOST REACTION
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
KIDNEYS
LABELLING
NUCLEI
ODD-EVEN NUCLEI
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANS
PATHOLOGICAL CHANGES
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIONUCLIDE KINETICS
RADIOPROTECTIVE SUBSTANCES
SCINTISCANNING
SUBCELLULAR DISTRIBUTION
TECHNETIUM 99
TECHNETIUM ISOTOPES
TISSUE DISTRIBUTION
TOXICITY
TRANSPLANTS
USES
YEARS LIVING RADIOISOTOPES