Radiorenography in Clinical Transplantation

Abstract

I131-hippuran renography was performed in connection with 21 homologous kidney transplantations in man. A total of 348 renograms were obtained and have been compared with the clinical course. The post-operative renograms had a normal appearance when ischaemia lasted less than 42 minutes. Longer ischaemia times first caused the excretion phase to disappear, giving an accumulation curve. The uptake phase was considerably more resistant, being present even when ischaemia lasted more than 6 hours. The presence of an uptake phase, however small, implies that blood is reaching the renal cortex. This provides a convenient indicator of circulation in the transplant. The excretion phase of the renogram is affected by all factors, such as impaired urinary production and urinary flow. The renogram generally displays typical changes in conjunction with rejection, sometimes before other symptoms can be detected. Renograms taken at an early stage can be used to distinguish between an oliguria due to imminent rejection and oliguria from obstructed urinary flow.