Complications of renal transplantation: appearances using Tc-99m-DTPA

Dynamic renal imaging has now become an essential part of the management of patients with renal transplants. In this study of over 2900 renal transplant scans, the authors have produced a compendium of the abnormal appearances that they have encountered. Apart from the most commonly seen complications, those of acute tubular necrosis and rejection, we now recognize many different complications. These can be classified as urinary (e.g., leaks and obstruction), vascular (e.g., hematomas and infarcts), or a miscellaneous group that includes lymphoceles. Many of these may cause problems in scan interpretation by masquerading as episodes of rejection. Recognition of these patterns can prevent patients from receiving unnecessary antirejection therapy and also enable the physician to ask for the correct investigation in reaching an accurate diagnosis.