The temporal and pathological significance of perfusion failure following renal transplantation.

Serial dynamic studies with 99mTc-DTPA are a useful method of monitoring renal transplants. Radionuclide images obtained within 24 hours after surgery and at regular intervals thereafter can identify pathological conditions. The decline or absence of perfusion, coupled with the elapsed time following surgery, can be used to differentiate vascular occlusion or hyperacute rejection from acute rejection, acute tubular necrosis, or accelerated or chronic rejection. 99mTc-pyrophosphate can be used to simultaneously evaluate transplant function and locate possible aseptic necrosis of bone. Both studies are noninvasive and have been performed safely on numerous occasions over a period of several years.