Estudio de los hallazgos de la gammagrafía renal inmediata y su influencia en la supervivencia del injerto renal

Abstract

Introduction: We assessed the effect of the findings of the renal gammagraphy (99mTc-DTPA) taken in the first 24 hours after the transplant in the survival of the kidney transplant. Materials and method: We retrospectively studied 413 kidney transplants carried out between January 1994 and December 2008, with emphasis on normal gammagraphic findings or alterations in the vascular, parenchymal and excretory stages, as well as their effect on the survival of the graft. Results: Of the 413 transplants, 44 (10.7%) presented alterations in the vascular stage, 256 (62%) in the parenchymal stage and 269 (65.1%) in the excretory stage. The mean follow-up of the entire group was 72.5 months (± 54.1 DE). The univariate analysis shows that the survival of the graft is significantly less in patients with alterations in the vascular stage (OR: 3; IC 95% 1.9 — 4.9 p < 0.001), in the excretory stage (OR: 2.5; IC 95% 1.5 - 4; p = <0.001) in the parenchymal stage (OR: 2.21; IC 95% 1.3-3.36; p = 0.001). The multivariate studies of the gammagraphic variables that affect the survival of the graft show that the presence of alterations in the vascular stage (OR: 3; IC 95% 1.9-4.9; p < 0.001) in the parenchymal stage (OR: 2; IC 95% 1.2-3.3; p = 0.005) are directly related to survival. This data is also confirmed by means of the actuarial survival analysis of the graft at 3 and 5 years. Conclusions: The presence of alterations in the vascular stage and in the parenchymal stage of the renal gammagraphy immediately after the transplant are variables that affect the survival of the graft.