ESPN 51th Annual Meeting

ESPN 2018


 
Pediatric renal transplant scintigraphy in evaluation of delayed graft function
BULENT YAZICI 1 IPEK KAPLAN BULUT 2 SEVGIN TANER 2 AYLIN ORAL 1

1- EGE UNIVERSITY MEDICAL FACULTY,DEPARTMENT OF NUCLEAR MEDICINE
2- EGE UNIVERSITY MEDICAL FACULTY, DEPARTMENT OF PEDIATRIC NEHPROLOGY
 
Introduction:

 In this study, quantitative indices of renal transplant scintigraphies (RTS) performed within 2 days after transplantation in pediatric patients were analyzed for evaluation of delayed graft function (DGF).

Material and methods:

Pediatric patients (N=56; 30 deceased, 26 living donor) to whom kidney transplantation was performed between 2012 and 2018 were retrospectively analyzed.  Eight patients (3 photopenic kidneys due to vascular thrombosis, 2 en-bloc transplants and 3 with improper bolus of injection) were excluded from the study. The indices of Hilson’s perfusion index (HI), graft index (GI), time between peak perfusion and peak iliac artery (ΔP) and the ratios of peak perfusion to plateau (P:Pl), peak perfusion to peak iliac artery (P:A) and peak perfusion to peak uptake (P:U) counts were obtained. In 14 patients (almost all were under 9 years old), because iliac artery was not be well visualized, the indices related to iliac artery (HI, GI, ΔP and P:A) could not be calculated.

Results:

Seven of 48 patients had DGF. Differences of the mean values of GI and P:U were significant (p<0.05) between DGF and normal groups. But the indices of HI, ΔP, P:PL and P:A were nonsignificant. The ROC curve analysis was used to assess the ability of the significant indices (GI and P:U) in identifying DGF. With regard to area under the curve (AUC), accuracy of GI (AUC of GI=0.91) was higher than P:U (AUC of P:U=0.83).

Conclusions:

We thought that GI of RTS performed within 2 days after transplantation is useful in identifying DGF. It can also be considered that P:U is the only index that can be used in pediatric RTSs with no or faint visualization of iliac artery when GI cannot be calculated.