張天佑¹、張兆祥¹、陳怡儒²、林清淵³、黃秋錦²、賴斌欽²、黃志平¹、蕭博任¹

¹中國附醫泌尿部、²中國附醫腎臟部、³中國附設兒童醫院兒童腎臟科

 Can donor Tc-99m diethylene triamine pentaacetic acid renal scan predict graft function recovery in living donor kidney transplant?

Tian-You Chang¹/Chao-Hsiang Chang^1/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.

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.