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Serial quantitative 99mTc DTPA imaging in CMV-associated renal allograft dysfunction
D Carrington1, H Mocan, T J Beattie
1Regional Virus Laboratory, Ruchill Hospital, Glasgow, United Kingdom.
Clinical Nephrology
|September 1, 1987
Summary
Cytomegalovirus (CMV) infection can cause kidney transplant dysfunction. Serial imaging and antibody tests helped identify CMV, distinguishing it from acute rejection and preventing unnecessary immunosuppression.
Area of Science:
- Nephrology
- Transplant Immunology
- Infectious Diseases
Background:
- Renal allograft dysfunction following transplantation can be challenging to diagnose, with cytomegalovirus (CMV) infection being a significant concern.
- Distinguishing CMV-associated dysfunction from acute rejection is crucial for appropriate patient management and optimizing graft survival.
Observation:
- Two cases of renal allograft dysfunction were monitored using technetium-99m diethylenetriamine penta-acetate (99mTc DTPA) imaging and CMV-specific fluorescent antibody tests.
- One patient presented with primary CMV disease 25 days post-transplant, while the second experienced CMV reactivation/reinfection 78 days post-transplant.
Findings:
- The 99mTc DTPA perfusion index remained unchanged during CMV illness in both cases, indicating no acute rejection.
- This lack of rejection indicators correlated with a swift recovery of kidney graft function.
Implications:
- Combined use of 99mTc DTPA imaging and CMV antibody tests aids in diagnosing CMV-associated allograft dysfunction.
- Early identification of CMV infection can prevent the escalation of immunosuppression, thereby reducing risks to the allograft.