RELEVANCE OF TC-99M DMSA SCINTIGRAPHY IN RENAL-TRANSPLANT PARENCHYMALIMAGING

Tc-99m DMSA renal scintigraphy was performed in 40 renal grafts. Cyclo sporin A and glucocorticoids were given to all patients as antirejecti on therapy, and 11 also were given azathioprine. The kidneys were tran splanted 1 to 97 months before the investigation. Seventy percent of k idneys had diffusely altered distribution of Tc-99m DMSA, and 43% had focal clear-cut parenchymal defects. The frequency of parenchymal defe cts observed on the DMSA scans was higher in patients who suffered man ifest acute rejection episodes (8/16 versus 9/24 patients, borderline significance, P < 0.06), but had no relation to the living or cadaveri c donor transplant or its function. A combination of peritubular edema and interstitial fibrosis is considered the most probable explanation of diffuse changes. The high frequency of clear-cut parenchymal defec ts most likely results from symptomatic or asymptomatic rejection epis odes complicated by renal transplant infarcts.