External monitoring of kidney transplant function using Tc-99m(Sn)DTPA

The purpose of this study was to evaluate the use of an external counting technique to provide daily monitoring of kidney transplant function by measuring the renal clearance of Tc-99m(Sn)DTPA. During the first few weeks following transplant, 15 patients had their renal clearance of Tc-99m DTPA measured daily over periods of 5-24 hr. Clearance rates were compared with daily plasma creatinine levels, and the effects of diurnal variation, drug treatment, and physical activity noted. The results show that any significant fall in clearance rate of chelate, indicating a rejection episode, preceded a rise in plasma creatinine levels by at least 24 hr. One episode of transplant failure presented as a sudden deterioration in clearance rate of chelate; in the others the change was more gradual but was still apparent within hours. It is considered that this noninvasive, low-dose, easy-to-perform technique is of considerable value in extended daily monitoring of renal function and is superior to standard daily or twice-weekly renography for the early detection of transplant rejection.