TECHNETIUM-99M-MAG3 SCINTIGRAPHY IN ACUTE-RENAL-FAILURE AFTER TRANSPLANTATION - A MARKER OF VIABILITY AND PROGNOSIS

This study assessed Tc-99m-mercaptoacetyltriglycine (MAG3) for determi nation of renal transplant prognosis for recovery in patients with ear ly postoperative dysfunction, The postulate tested was that good trace r extraction may imply high likelihood of recovery, while poor extract ion may confer a poor prognosis. Methods: A 2-min image acquired 1 min after MAG3 administration, named a cortical uptake phase (CUP) image, was visually analyzed according to standardized semiquantitative guid elines, Interpretation was expressed in tubular injury severity scores (TISS) that ranged from 1 (a normally functioning renal transplant) t o 6 (a photopenic defect in place of renal transplant). Results: The s tudy analyzed 64 patients (35 men, 29 women, age 45.9 +/- 14 yr). All five patients with TISS of 6 or 5 lost the transplant. Only 1 of 10 pa tients with TISS of 4 lost the transplant. All patients with TISS of l ess than 4 recovered renal transplant function, Conclusion: This study suggests that MAG3 scan (the CUP image specifically) is an accurate p rognosticator in patients with early postoperative renal transplant dy sfunction, Reproduction of these results in a larger population and ot her institutions is necessary before clinical implementation of this m ethodology.