The value of doppler ultrasonography and renal scintigraphy in the long term outcomes of pedi̇atri̇c renal transplant pati̇ents

Doppler ultrasonography (DUSG) and Tc-99m-DTPA renal scintigraphy are useful, noninvasive diagnostic tools for the management and follow-up of the transplanted kidney. The measurement of intrarenal arterial resistance index (RI) by doppler ultrasound, has proven to reliably predict short-term allograft function. Although there were more studies about utility of renal scintigraphy with 99mTc-DTPA in the evaluation of patients during the early posttransplantation period for acute renal graft complications, there was no any study about the predictive value of DTPA parameters for short and long-term allograft function. The current study was designed to assess the value of Doppler USG and DTPA performed during early period posttransplant period to predict short and longterm renal allograft function in pediatric transplant patients. We retrospectively analysed 70 (35 male, 35 female) kidney transplant patients. The mean age of patients was 13.61±3.99 (range: 3,50-18.00) years. The mean follow up time of patients was 41.66±30,37 (range: 12-132) months. They underwent Tc-99m DTPA renal scintigraphy and doppler ultrasonography at 3rd and 7th posttransplant day. Resistive index (RI) values obtained by doppler USG were not correlated with allograft function at 1 year and at last control. GFR obtained by Tc-99m DTPA at 3rd and 7th postransplant day was correlated with allograft function at 1 year and last control (p<0.05). Uptake at 3rd postransplant day was also correlated with allograft function at 1 year and last control. But there were no any correlation between the uptake at 7th posttransplant day and allograft function at 1 year and last control. In patients with at least 2 year follow-up after transplantation, only uptake at 3rd posttransplant day were correlated with allograft function at last control. Systolic blood pressure, pulse pressure, delayed graft function are the risk factors for increased RI (p<0.05). Cyclosporin and tacrolimus level, number of human leukocyte antigen (HLA) mismatches, hyperlipidemia, donor and recepient ages, donor and recepient sex, body mass index were not correlated with RI. BUN and creatinine level of patients with RI ≥ 0.7 were higher than that of patients with RI <0.7. Sodium level of patients with RI ≥ 0.7 were lower than that of patients with RI<0.7. Parameters obtained by Tc-99m-DTPA performed in the first week of postransplantation period h have a predictive value for short and long-term outcomes of renal transplanted patients. Although Rİ obtained by DUSG has no predictive value for short and long term allograft survival, because of allograft functions are compatible with Rİ values, serial Rİ measurement can valuable in the follow up of renal transplant patients.