Demonstration of the kidney functions obtained from a cadaveric donor in a rat model by the dynamic renal scintigraphy

Renal transplantation is the most distinguished treatment method which provides important positive changes for the end stage renal failure patients. Half of the present renal transplantations are carried out through the cadaveric donors. These donors are the ones who have enough time for refering to them for the organ supplyment organisation since their brain death criteria already full filled and their organs are still perfused through the vital support applications. Dynamic renal scintigraphy contributes greatly in the evaluation of transplantable kidneys because it provides important data about the functions of these kidneys. In this study we aimed to determine the role of the changes in the kidney functions detected through the Tc-99m renal scintigraphy and the histopathological changes in the kidney and the biochemical changes in the brain death model in rats. In this study, dynamic renal scintigraphy and image analysis were carried out by Tc-99m DTPA one day before and just after the production of brain death model in ten rats. Tc 99m DTPA renal scintigraphy was performed under entubation and monitorization circumstances. Urea and creatinin levels of venous blood samples of the rats were measured before and after the brain death. Wilcoxon test (nonparametric test) was numeric variables for the comparison of the parameters that were obtained before and after the brain death (scintigraphical quantitive results before and after the brain death and urea and creatinin levels). Significant increase in the GFR, left kidney Tmax, urea and creatinin levels after the brain death were observed in comparision with the levels before the brain death (p<0,05). Although an increase in the right kidney Tmax levels after the brain death was also observed, it was not statistically significant (p=0,066). In the visual evaluation of the renogram curves; the increase in the concentration functions and significant delay in the excretion functions were observed after the brain death. Common principal histopathological changes were the congestion in the veins, hydropic degeneration in the tubule epithelium and focal lymphocytic infiltrations in the kidney graft tissues of the all rats. In addition, all rats brain death were confirmed histopathologically. Histopathological findings were concordant with acute tubular damage in the kidney. As a result, the quantitative and visual findings of the Tc-99m DTPA renal scintigraphy were found releated with the histopathological findings observed in the early periods of the brain death. These results showed that Tc-99m DTPA renal scintigraphy is a reliable and effective method for the graft function evaluation. Comprehensive experimental and even human studies on this topic will increase the number and the success of the renal transplantations. Keywords: Brain death, Tc 99m DTPA, renal functions.