Utility of postsurgical renal scintigraphy to predict one-year outcome of renal transplants in patients with delayed graft function
Utility of postsurgical renal scintigraphy to predict one-year outcome of renal transplants in patients with delayed graft function
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DOI：
10.1097/mnm.0b013e3283446297
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发表时间：
2011-04-01
影响因子：
1.5
通讯作者：
Mariano-Goulart, Denis
中科院分区：
文献类型：
--
作者：
Guignard, Renaud;Mourad, Georges;Mariano-Goulart, Denis
目的移植肾功能延迟恢复是肾移植术后常见的并发症，严重影响移植肾的存活.本研究的目的是评估移植后立即在此population.Methods移植肾功能延迟的100例患者的肾移植术后的定量血流动力学参数的预后价值。所有患者均在移植后72 h内接受了（99 m）Tc-巯基乙酰基三甘氨酸肾动脉造影，并随访1年。基于血管造影和肾小管阶段的时间-活性曲线评价各种同位素参数。从受试者工作特征曲线中推导出每个参数的阈值，以研究它们对1年移植成功率的预测值。或移植物摄取/灌注比在成功移植的患者中显著更高结论血管参数对肾移植术后1年肾功能衰竭的预后有重要意义，尤其是Kirchner指数对肾移植1年成功率的阴性预测值大于90%。此外，同位素参数评估肾单位的功能质量或功能性肾储备似乎是相关的预后工具方面的1年的结果。因此，早期（99 m）Tc-巯基乙酰基三甘氨酸肾动脉造影评估血管和肾功能似乎是一个强有力的工具，在建立1年的移植肾预后。Nucl Med Commun 32：314-319（C）2011 Wolters Kluwer Health垂直栏Lippincott威廉姆斯& Wilkins。
Objective Delayed graft function is a frequent complication after kidney transplantation impacting aversely on graft survival. The aim of this study was to assess the prognostic value of quantitative scintigraphic parameters immediately after transplantation in this population.Methods One hundred patients with renal transplants suffering from delayed graft function were included in this study. All patients underwent (99m)Tc-mercaptoacetyltriglycine renal scintigraphy within 72 h of transplantation and were followed for 1 year. Various isotopic parameters were evaluated based on time-activity curves for angiographic and tubular phases. Threshold values for each parameter were derived from receiver operating characteristic curves to study their predictive values for transplant success at 1 year.Results Mean values of the Kirchner index, tubular function slope, graft/aorta perfusion ratio, or graft uptake/perfusion ratio were significantly higher in successfully grafted patients (P1.4) was found to be an independent prognostic factor for 1-year renal graft failure.Conclusion Our study confirms the prognostic value of vascular parameters in renal transplants, especially the Kirchner index whose negative predictive value was more than 90% for kidney transplantation 1-year success. In addition, isotopic parameters assessing the nephronic functional mass or the functional renal reserve seemed to be relevant prognostic tools with respect to 1-year outcomes. Therefore, the assessment of vascularization and renal function using an early (99m)Tc-mercaptoacetyltriglycine renal scintigraphy seems to be a powerful tool in establishing 1-year prognosis of renal allografts. Nucl Med Commun 32:314-319 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.