FOLLOW-UP OF TRANSPLANTED PATIENTS WITH R ADIONUCLIDES

Nuclear medicine procedures have special indications in the follow-up of transplanted patients: In case of renal transplantation perfusion, function (glomerular filtration) and urinary flow measured by bolus ap plication of Tc-99m-DTPA is an important tool to detect and monitor ac ute tubular necrosis, rejection, urinary leakage, obstruction or vascu lar complications. This method is used for pancreatic grafts, too. To exclude rejection in case of heart transplantation more than one year after operation the antimyosin antibody scintigraphy is introduced avo iding biopsies. The radionuclide ventriculography is able to monitor h eart function by determining the ejection fraction. Cholescintigraphy in liver transplants is sensitive to detect complications of bile flow . In case of an auxiliary liver transplantation a competition between two livers has been described. This method allows a distinction of fun ctional performance of donor and recipient liver. The same problem is solved by ventilation-perfusion scan in lung transplants. Bone scintig raphy is of prognostic value for graft viability. Other radionuclide e xaminations have been developed to measure perfusion, glucose-, fat-me tabolism to detect rejection episodes, abscesses or tumor recurrencies .