Case Author(s): Scott Winner, M.D. and Tom R. Miller, M.D., Ph.D. , 01/10/97 . Rating: #D2, #Q4

Diagnosis: Infarcted renal transplant

Brief history:

40-year old woman with a renal transplant in the right iliac fossa.

Images:

Anterior pelvic radionuclide angiogram four weeks after transplantation

View main image(rs) in a separate image viewer

View second image(rs). Sequential dynamic images four weeks post-transplant

View third image(rs). Anterior pelvic radionuclide images two weeks after the first study

View fourth image(rs). Sequential dynamic images from the second study

Full history/Diagnosis is available below

Diagnosis: Infarcted renal transplant

Full history:

40-year old diabetic female with end-stage renal disease. She received a renal transplant and was doint well at the time of the first study. The patient presented in renal failure on at the time of the second study.

Radiopharmaceutical:

7.6 mCi Tc-99m MAG3 i.v.

Findings:

The first renal transplant scintigraphy demonstrates prompt perfusion to the transplanted kidney with only mildly delayed uptake and excretion of tracer. The second study two weeks later (when the patient1s creatinine was 7.4) demonstrates no appreciable perfusion, uptake, or excretion of tracer by the transplant.

Discussion:

The lack of appreciable perfusion to the transplanted kidney on the second study was strong evidence that the transplant was not perfused and, hence, infarcted. Because of the less likely possibility that the findings were due to severe renal failure, a sonogram was performed, showing no blood flow to the kidney.

ACR Codes and Keywords:

References and General Discussion of Renal Scintigraphy (Anatomic field:Genitourinary System, Category:Effect of Trauma)

Search for similar cases.

Edit this case

Add comments about this case

Read comments about this case

Return to the Teaching File home page.

Case number: rs013

Copyright by Wash U MO