RESUMO
AIM: The aim of this study was to investigate the usefulness of hepatobiliary scintigraphy for the evaluation of liver grafts in the early postoperative period in patients receiving liver transplants from living related donors. MATERIALS AND METHODS: Fifty-six liver transplant recipients who received grafts from living related donors were included in the study. We examined the hepatobiliary scintigraphies of all patients, which were performed 7 to 10 days after the transplantation. The scintigraphic images were evaluated visually in terms of hepatic parenchymal function and biliary and vascular complications. RESULTS: In 44/56 recipients, hepatobiliary scintigraphy was completely normal in the early postoperative period. However, in 6/56 cases, scintigraphy was interpreted to show parenchymal dysfunction. In these patients, histopathologic confirmation by biopsies revealed four cases of hepatocellular damage/cholestasis, one acute rejection, and one cholangitis. In 3/56 patients, hepatobiliary scintigraphy demonstrated a hypoactive area in the liver graft; however, the other areas showed normal function. When the abdominal computed tomography (CT) and CT angiography were evaluated, these hypoactive areas were discovered to be related to minor vascular problems. In 3/56 liver graft recipients whose grafts showed normal parenchymal function scintigraphically, images were interpreted to indicate bile leak because accumulation of tracer was seen at an abnormal physiological site. CONCLUSION: Hepatobiliary scintigraphy, which is a noninvasive and objective method, is useful to assess grafts in the early postoperative period among patients who received liver transplants from living related donors.
Assuntos
Vesícula Biliar/diagnóstico por imagem , Hepatectomia/métodos , Fígado/diagnóstico por imagem , Doadores Vivos , Tecnécio , Coleta de Tecidos e Órgãos/métodos , Adolescente , Adulto , Família , Feminino , Humanos , Iminoácidos , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Cintilografia , Compostos RadiofarmacêuticosRESUMO
The aim of this study was to compare the outcome of paired grafts in renal recipients from the same cadaveric donor using quantitative Tc-99m DTPA scintigraphy. Fifty recipients from 25 cadaveric donors were followed for a median period of 3 years. Serial Tc-99m DTPA scintigraphy was performed starting on the third posttransplant day and images evaluated quantitatively. The quantitative parameters included Hilson's perfusion index, time to maximum activity, time to half of maximum activity, the ratio of the graft activity at 20 to 3 minutes, and glomerular filtration rate. In the early postoperative period, 20 of 25 paired kidneys showed similar performances. At the end of the first year 22 of 25 pairs showed a similar evolution. At the end of the third year, the number was 21 of 25. We concluded that if cold ischemia time was prudent, there was no difference in graft outcome between the first and the second recipient of a renal transplant from the same cadaveric donor.
Assuntos
Transplante de Rim/fisiologia , Rim/diagnóstico por imagem , Doadores de Tecidos/estatística & dados numéricos , Cadáver , Estudos de Coortes , Seguimentos , Humanos , Cintilografia , Compostos Radiofarmacêuticos , Pentetato de Tecnécio Tc 99m , Fatores de TempoAssuntos
Isquemia , Transplante de Rim/fisiologia , Rim , Doadores de Tecidos , Adulto , Biópsia por Agulha , Cadáver , Feminino , Seguimentos , Humanos , Rim/irrigação sanguínea , Rim/diagnóstico por imagem , Transplante de Rim/patologia , Masculino , Preservação de Órgãos/métodos , Cintilografia , Compostos Radiofarmacêuticos , Pentetato de Tecnécio Tc 99m , Resultado do TratamentoAssuntos
Transplante de Rim/fisiologia , Pentetato de Tecnécio Tc 99m , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Terapia de Imunossupressão/métodos , Transplante de Rim/imunologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Vírus do Sarcoma do Macaco-Barrigudo , Doadores de Tecidos/provisão & distribuição , Resultado do TratamentoAssuntos
Transplante de Rim/fisiologia , Rim/diagnóstico por imagem , Pentetato de Tecnécio Tc 99m/uso terapêutico , Adolescente , Biópsia por Agulha , Cadáver , Criança , Feminino , Câmaras gama , Taxa de Filtração Glomerular , Meia-Vida , Humanos , Transplante de Rim/patologia , Doadores Vivos , Masculino , Perfusão , Período Pós-Operatório , Cintilografia , Compostos Radiofarmacêuticos/farmacocinética , Compostos Radiofarmacêuticos/uso terapêutico , Pentetato de Tecnécio Tc 99m/farmacocinética , Doadores de TecidosAssuntos
Fatores Etários , Transplante de Rim/estatística & dados numéricos , Rim/diagnóstico por imagem , Doadores de Tecidos/estatística & dados numéricos , Adulto , Cadáver , Feminino , Humanos , Transplante de Rim/métodos , Transplante de Rim/fisiologia , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Cintilografia , Compostos Radiofarmacêuticos , Pentetato de Tecnécio Tc 99mAssuntos
Vesícula Biliar/diagnóstico por imagem , Sobrevivência de Enxerto/fisiologia , Transplante de Fígado/fisiologia , Fígado/diagnóstico por imagem , Adolescente , Compostos de Anilina , Feminino , Glicina , Humanos , Iminoácidos , Masculino , Compostos de Organotecnécio , Cintilografia , Compostos Radiofarmacêuticos , Doadores de Tecidos/estatística & dados numéricos , Resultado do TratamentoAssuntos
Transplante de Fígado/fisiologia , Fígado/diagnóstico por imagem , Biópsia por Agulha , Seguimentos , Rejeição de Enxerto/patologia , Humanos , Falência Hepática/cirurgia , Testes de Função Hepática , Transplante de Fígado/patologia , Cintilografia , Fatores de Tempo , Transplante HeterotópicoRESUMO
This study evaluates brain perfusion in long-term inhalant abusers of toluene, acetone, benzene and derivatives. Ten patients in the age range 16-18 years (mean, 17.3+/-0.67 years), who had been inhalant dependent for a mean period of 48.3+/-6.2 months, but who had stopped using inhalants for 1-11 months (mean, 5.4+/-2.1 months), and ten controls (mean age, 17.3+/-0.67 years) were included in the study. Psychiatric tests, biochemical tests and Tc-99m-hexamethylpropyleneamine oxime (Tc-99m-HMPAO) brain single photon emission computed tomography (SPECT) were performed on all patients. Brain SPECT images were evaluated qualitatively and quantitatively. The mean IQ level was found to be 84 (by psychological tests). Brain SPECT showed non-homogeneous Tc-99m-HMPAO uptake and hypoperfusion areas in all patients (five left temporal, one right temporal, two left temporal plus bilateral parietooccipital, one biparietal and one left temporoparietal). Seven patients had hyperperfused foci (unifocal in five patients and multifocal in two patients). Six hyperperfused foci were in a parietal and one in a temporoparietal location. This study suggests that inhalant dependents exhibit serious abnormalities in brain SPECT images, including hypo-hyperperfusion foci and non-homogeneous uptake of the radiopharmaceutical. A further study with a larger number of patients and long-term follow-up may help to reach a more specific conclusion.