The Clinical Utility of Indium-111 Labeled Platelet Scintigraphy in the Diagnoses of Renal Transplant Rejection

  • Gary V. Desir
  • Margaret Bia
  • Robert C. Lange
  • Eileen O. Smith
  • Wayne Flye
  • Michael Kashgarian
  • Martin Schiff
  • Michael D. Ezekowitz
Chapter
Part of the Developments in Nuclear Medicine book series (DNUM, volume 17)

Abstract

Acute rejection, which often threatens graft survival in kidney transplant recipients, should be diagnosed and treated urgently. There is indirect evidence that the earlier treatment is initiated, the better are the chances of preserving graft function (1). At present, allograft rejection is best diagnosed histologically (2). Since kidney biopsy is an invasive procedure which carries a small but significant risk of major complications (3) it is usually obtained only when acute rejection is strongly suspected on clinical grounds, that is after renal damage has already occurred. In the first month following transplantation, when the incidence of acute rejection is very high, clinical parameters, namely graft pain, tenderness and enlargement and fever, are often not helpful since acute rejection can occur in their absence, especially in patients maintained on cyclosporine (4). Moreover, rejection is notoriously difficult to diagnose clinically in the setting of post operative acute tubular necrosis since urine output is decreased and since serum creatinine, the single most diagnostic biochemical parameter, is already markedly elevated. For these reasons, a non invasive test that detects rejection before it is clinically apparent is very much needed.

Keywords

Acute Rejection Renal Allograft Acute Tubular Necrosis Left Ventricular Thrombus Renal Allograft Rejection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Kluwer Academic Publishers 1990

Authors and Affiliations

  • Gary V. Desir
    • 1
  • Margaret Bia
    • 1
  • Robert C. Lange
    • 1
  • Eileen O. Smith
    • 1
  • Wayne Flye
    • 1
  • Michael Kashgarian
    • 1
  • Martin Schiff
    • 1
  • Michael D. Ezekowitz
    • 1
  1. 1.Departments of Medicine, Radiology, Surgery and PathologyYale University School of MedicineUSA

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