308 KB15 KB199220251999Bubić-Filipi, LjubicaCrnković, SunčanaDodig, DamirGrošev, DarkoHuić, DraženPoropat, MirjanaPuretić, Zvonimirštevilka:3letnik:33str. 215-220COBISSID_HOST:10782425ISSN:1318-2099URN:URN:NBN:SI:doc-6GSYM0X5enCroatian Medical Association - Croatian Society of RadiologySlovenian Medical Society - Section of RadiologyRadiology and oncology (Ljubljana)Blood supplyGraft rejectionKidneyKidney transplantationKidney tubular necrosis, acuteRadionuclide imagingRenal transplant blood flow in patients with acute tubular necrosis| Krni obtok v ledvičnih transplantatih pri bolnikih z akutno tubularno nekrozo|Background. Since there are contradictions in data, this study was aimed to investigate the quantity of renal transplant blood flow in patients affected by acute tubular necrosis (ATN). Subjects and methods. During the four year period,179 examinations were performed in 60 patients (31 female, 29 male, median age 37 years, range 11-62 years, 42 cadaveric and 18 living related transplants, median follow-up 21 months) using Tc-99m-pertechnetate and 1131-OIH. Renal blood flow was calculated from the first-pass time activity curves generated over the kidney and aorta and expressed as a percentage of cardiac output (RBF/CO). Results. In 53 examinations of the patients with ATN the mean RBF/CO was significantly lower than in 60 examinations of patients with normal graft function (6.5 %+-3.4 %,11.4 %+-3.4 %, respectively, p = 9.6 x 10-12), and similar to the mean values of 49 examinations with acute rejection (AR) and 17 examinations with the combination of ATN and AR (73 %+-3.4 %, 5.8 %+-2.5 %, respectively, p > 0.05). In the patients with ATN meanRBF/CO were significantly related to creatinin serum (CS) value (CS<500 mmol/I - 8.0 %+-3.0 %, CS>1000 mmol/I - 5.2 % +- 2.2 %, p<0.05) and to 1131 OIH renogram patterns (some OIH excretion from renal parenchyma during the examination - 7.0 %+-3.5 %, no excretion - 5.1%+- 2.2 %, p< 0. 05). Conclusions. Renal transplant blood flow is clearly diminished in ATN, similarly as in AR, and significantly related to the graft functionIzhodišča. Zaradi nasprotujočih se podatkov smo se odločili za raziskavo ledvičnega krvnega obtoka (RBF) v ledvičnih transplantatih pri bolnikih z akutno tubularno nekrozo (ATN). Bolniki in metode. V štirih letih smo opravili179 preiskav s Tc-99m pertehnetatom in I-131-OlH na 60 bolnikih (od teh je bilo 31 žensk in 29 moških, njihova srednja starost je bila 37 let in sicer od 11 do 62 let, presajenih je bilo 42 kadavrskih ledvic in 18 ledvic odživih darovalcev sorodnikov, kontrolno sledenje je v povrečju trajalo 21 mesecev). Krvni obtok smo izračunali iz časovnih krivulj prvega pretoka skozi ledvice in aorto in ga izrazili v odstotkih iztisnega volumna krvi iz srca (RBF/CO). Rezultati. V 53 preiskavah bolnikov z ATN je bil povprečni RBF/CO precej nižji kot pri 60 bolnikih z normalnim delovanjem transplantirane ledvice (6,5 %+- 3,4%; 11,4%+- 3,4%; p=9,6 x10-12) in enak srednjim vrednostim49 preiskav bolnikov z akutnim zavračanjem transplantirane ledvice ter prav tako enak 17 preiskavam bolnikov z ATN in z akutnim zavračanjem transplantirane ledvice (7,3%+- 3,4 %; 5,8%+- 2,5 %; p=0,005). Pri bolnikih z ATN so bile vrednosti RBF/CO v sorazmerju z vrednostjo serumskega kreatinina (KS<500 mmol/1- 8,0 % 3,0 %; KS >1000 mmol/I - 5,2 %+- 2,2 %; p< 0,05) in z renogrami z I-131 OIH (delno izločanje OIH iz ledvičnega parenhima med preiskavo - 7,0 %+- 3,5 %; brez izločanja - 5,1 %+-2,2 %; p=<0,005. Zaključek.Krvni obtok v transplantiranih ledvicah se očitno znatno zmanjša tako pri ATN kot pri akutnem zavračanju in je značilno odvisen od delovanja transplatirane ledviceTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaOnkološki inštitut Ljubljana