[Value of DTPA scintigraphy following furosemide injection in the diagnosis of obstruction in renal transplantation].

Following development of dilatation on ultrasonography and/or intravenous pyelography in the course of follow-up after renal transplantation, a dilatation due to obstruction must be distinguished from dilatation without obstruction. DTPA scintigraphy is frequently used for the diagnosis of hydronephrosis caused by an anomaly of the pyeloureteric junction. In renal transplantation, this examination is used less frequently. The authors report a prospective study of Lasilix scintigraphy in the diagnosis of obstruction in 30 renal transplant. The results presenting with stasis of their transplant. The results were classified into 4 groups according to O'Reilly's classification and were compared with the course of the stasis. Lasilix scintigraphy demonstrated a specificity of 93% and a sensitivity of 63%. The role of stasis in the deterioration of the renal function of a transplant is difficult to evaluate. In cases of stasis with altered renal function, the authors propose the addition of study of the renal parenchyma by renal biopsy, which excludes rejection and Cyclosporin nephrotoxicity. When the renal biopsy is normal, the kidney should be drained by percutaneous nephrostomy which evaluates the capacity of recovery of renal function and determines the indication for antegrade dilatation or surgical repair.