Can donor Tc-99m diethylene triamine pentaacetic acid renal scan predict graft function recovery in living donor kidney transplant?
Tian-You Chang1/Chao-Hsiang Chang1/I-Ru Chen2/Ching-Yuang Lin3/ Chiu-Ching Huang2/Ping-Chin Lai2/ /Chi-Ping Huang1/Po-Jen Hsiao1
1Department of Urology, China Medical University Hospital, Taichung, Taiwan
2Department of Nephrology, China Medical University Hospital, Taichung, Taiwan
3Department of Children Nephrology, China Medical University Children’s Hospital, Taichung, Taiwan
Pre-operative renal function study with Tc99m- diethylene triamine pentaacetic acid(DTPA) was a regular exam for donor in kidney transplantation to help predict the remaining renal function after donor nephrectomy. However, the association of DTPA renal scan with recipient renal function is rarely discuss. In this study, we evaluation the association of graft eGFR(by Tc99m-DTPA renal scan) and the recipient renal function recovery.
Materials and Methods:
This is a retrospective study that include patients who received living donor nephrectomy or living donor kidney transplantation between January 2009 and January 2020.We collect data including the underlying disease, perioperative renal function of both donor and recipient and the renal function of recipients 3 months after transplantations, preop Tc99m-DTPA renal scan in donor, mean operative time, and estimated blood loss. We compared the renal function between 1 wk post op and 3 month post op of the recipient. We defined the 3 month serum creatinine recovery(3msCrRe) as reduction of Cr >1.0 compared between 3 month and 1 wk postop.We then analysis the relation between graft GFR and the presence of delay graft recovery.
Overall 102 pairs of donors and recipients had received donor nephrectomy or renal implantation in our hospital. 10 donors that had no Tc99m-DTPA renal scan before operation was excluded. There are 5, 39, 31, 17 patients with graft kidney GFR >60, 50-60, 40-50,<40. The 7days postop eGFR of recipient were >90, 60-90, 30-60, <30 in 5, 39, 31, and 17 patients. The 3 months postop eGFR of recipients were >90, 60-90, 30-60, <30 in 6, 42,42,2 patients. We evaluated the association between patients who had delay recovery of renal function with the graft eGFR with chi-square exam and we found those who received graft with eGFR<40 had higher rate of delay 3msCrRe than those who received graft eGFR>40 (40%vs 9%, p=0.016). Besides, those who experience delay 3msCrRe had relatively poor renal function at 3 months.(81.8% vs 45%, p=0.049)
Those living kidney transplant recipient who receive poor graft function(graft eGFR<40) had higher rate of delay graft recovery and those who experience delay graft recovery had relative poor renal function at 3 months.