術前腎臟掃描與移植後受贈者長期的腎功能之相關性-五年期之追蹤

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

Relationship between Tc-99m diethylene triamine pentaacetic acid renal scan and long term recipient renal function- a-five-year follow up study

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

Purpose:

For living donor kidney transplant, pre-operative renal function study with Tc99m- diethylene triamine pentaacetic acid(DTPA) was a regular exam for predicting 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 in long t

Materials and Methods:

This is a retrospective cohort study that include patients who received living donor nephrectomy or living donor kidney implantation between January 2009 and March 2016.Data including the underlying disease, perioperative renal function of both donor and recipient and recipient renal function within 5 years after transplantations, preop Tc99m-DTPA renal scan in donor, mean operative time, and estimated blood loss were collected. We then analysis the relationship between graft GFR and renal function 24hr, 7days, 3months and each year after operation. The recipient were subgroup into four groups by the graft GFR(GFR >60, 50-60, 40-50,<40). We then draw the renal function and time curve for each group.

Results:

Overall, 58 pairs of donors and recipients had received donor nephrectomy or renal implantation in our hospital between January 2009 and march 2016. 10 donors had no Tc99m-DTPA renal scan before operation, thus they were excluded. There are 14, 21, 18, 6 recipients received transplantation with graft kidney GFR >60, 50-60, 40-50, <40. The averaged renal function at 24hr, 7days, 3months and each year after operation were 12.61, 60.01, 61.72, 69.36, 69.79, 62.82, 65.73, 62.81ml/min/1.73m2 for all patients. For the initial 24hr and 1wk, we found that recipient who received graft with GFR>60 had fastest renal function recovery(renal function: 51.71±67.32, 11.20±6.16, 11.22±5.07, 7.33±4.93 for graft GFR >60, 50-60, 40-50,<40). For Graft GFR 50-60, 40-50 recipient, their renal function return to plateau level within 1wk. For Graft GFR <40 patient, they need longer time for renal function recovery;approximately, 3 months. If follow up for 5 years, there was no statistically significant difference in renal function at 1y to 5yr among the four groups.

Conclusions:

Those living kidney transplant recipients who received poor graft function(graft GFR<40) had slower renal function recovery but it had no difference when follow up renal function for long term.