The influence of ischemia on 131I-Hippuran renograms performed after kidney transplantation and its prognostic value.

Within 72 hours after 289 uncomplicated cadaver kidney transplantations, 131I-ortho-iodo-hippurate renography was performed. The renographic changes caused by ischemic damage were correlated to the length of warm and cold ischemia times and followed during the recovery of graft function. Normal or slightly decreased phase 1 and 2 were seen in approximately 65 percent of the renograms if warm ischemia time was shorter than 15 min and the cold ischemic period less than 10 hours. For cold ischemia longer than 10 hours, the proportion was 30-60 percent. Warm ischemia time between 15 and 30 min caused a decrease of phase 1 and 2. Approximately 40 percent were normal or reduced if the cold ischemia time was less than 10 hours; for longer than 10 hours, the proportion was approximately 30 percent. Renograms with an excretion phase were mainly seen in the group with warm ischemia time less than 15 min combined with cold preservation for less than 20 hours. The phases of the post transplant renograms were closely correlated to the creatinine clearance. A normal or slightly decreased phase 1 or 2 was seen in patients with a clearance of 20-35 ml/min, moderately decreased phase was seen in the group with clearance of 10 ml/min, severely changed phase in the group with clearance of 0-5 ml/min. Correlating the onset of renal function to the initial posttransplant renogram showed immediate onset of function of 65 percent of the grafts with a normal or slightly decreased phase 1 or 2, as opposed to 15 percent of the grafts with moderately to severely decreased phases.(ABSTRACT TRUNCATED AT 250 WORDS)