Gençoğlu Esra Arzu, Aktaş Ayşe, Haberal Mehmet
Department of Nuclear Medicine, Transplantation, Baskent University Faculty of Medicine, Ankara, Turkey.
Exp Clin Transplant. 2014 Mar;12 Suppl 1:92-4.
The aim of this study was to evaluate the usefulness of the hepatic parenchymal retention index in the early diagnosis of parenchymal complications in liver transplant recipients as determined by hepatobiliary scintigraphy.
This retrospective study reviewed 100 liver transplant recipients who had undergone orthotopic liver transplant. In all cases, hepatobiliary scintigraphy images recorded 7 to 10 days posttransplant were quantitatively reinterpreted according to hepatic parenchymal retention index. The hepatocyte extraction fraction value was also calculated. Scintigraphic findings as well as clinical, laboratory, and biopsy results were assessed.
Quantitative analysis showed normal hepatocyte extraction fraction value in all subjects. However, significant differences in hepatic parenchymal retention index were observed. Thus, subjects were divided into 3 groups: group 1 (n=75), normal; group 2 (n=15), severely elevated; group 3 (n=10), mildly-to-moderately elevated hepatic parenchymal retention index. Evaluation of histopathological, clinical, and laboratory findings showed normal grafts in all group 1 recipients, acute rejection in all group 2 recipients, and hepatocyte damage/intrahepatic cholestasis in all group 3 recipients.
Based on these findings, we determined that hepatocyte extraction fraction value was not useful, whereas hepatic parenchymal retention index was beneficial for early and accurate diagnosis of parenchymal complications in liver transplant recipients.
本研究旨在评估肝实质滞留指数在肝移植受者实质并发症早期诊断中的有用性，该诊断通过肝胆闪烁显像确定。
这项回顾性研究纳入了100例行原位肝移植的肝移植受者。所有病例中，对移植后7至10天记录的肝胆闪烁显像图像，根据肝实质滞留指数进行定量重新解读。还计算了肝细胞摄取分数值。对闪烁显像结果以及临床、实验室和活检结果进行评估。
定量分析显示所有受试者的肝细胞摄取分数值均正常。然而，观察到肝实质滞留指数存在显著差异。因此，将受试者分为3组：第1组（n = 75），正常；第2组（n = 15），严重升高；第3组（n = 10），肝实质滞留指数轻度至中度升高。对组织病理学、临床和实验室检查结果的评估显示，第1组所有受者的移植物正常，第2组所有受者发生急性排斥反应，第3组所有受者存在肝细胞损伤/肝内胆汁淤积。
基于这些发现，我们确定肝细胞摄取分数值无用，而肝实质滞留指数有助于肝移植受者实质并发症的早期准确诊断。
