Tc-99m MAG3 renal scan of a renal transplant recipient, day 1 after transplant with oliguria, shows delayed excretion of tracer from the transplant kidney. Images in vascular phase (not shown) are normal (normal perfusion and uptake).
Facts
- May occur immediately or after an initial short period of allograft function
- Related to both donor and recipient factors
- More common in cadaveric kidneys of older donors who sustained warm ischemia time or prolonged hypotensive periods
- Presented with oliguria or anuria early after transplant
- Diagnosis made by exclusion of other factors. Traditional signs (tubular casts, low urine osmolality) not reliable if patients with native partially functioning kidneys
- Treatment: supportive, return to dialysis if anuric (expected recovery of renal function usually within 3 weeks)
Renal Scan
- Normal perfusion, variable uptake but no (or delayed) excretion
- Serial scans helpful in determining viability of oliguric kidneys, predicting recovery or deterioration
Reference:
Resnick MI, Older RA. Diagnosis of Genitourinary Disease, 2nd edition, 1997
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