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Nuklearmedizin 1993; 32(05): 215-221
DOI: 10.1055/s-0038-1632281
Übersichtsartikel
Schattauer GmbH

Funktionsszintigraphie in der Transplantatnachsorge[*]

Follow-Up of Transplanted Patients with Radionuclides
K. F. Gratz
1   Aus der Abteilung Nuklearmedizin und spezielle Biophysik, Zentrum Radiologie, Medizinische Hochschule Hannover und der Abteilung für Nuklearmedizin, Radiologische Klinik, Universitätskrankenhaus Eppendorf, Universität Hamburg, FRG
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Publication History

Eingegangen: 21 May 1993

Publication Date:
04 February 2018 (online)

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Zusammenfassung

Spezielle Indikationen für nuklearmedizinische Untersuchungen in der Transplantatnachsorge sind die Beurteilung von Perfusion, Funktion und Urinabfluß im postoperativen Verlauf nach Nieren-Tx u.a. mittels 99mTc-DTPA-Bolusstudie, bei einer kombinierten Tx gleichzeitig für das Pankreas-Tx geltend, am Herz-Tx die RNV zur Funktionsbeurteilung, die Antimyosin-Szintigraphie zum Ausschluß einer Abstoßungsreaktion in der Spätphase, die Choleszintigraphie zum Nachweis von Galleabflußstörungen nach Leber-Tx, nach auxiliärer Tx zur Beurteilung des Funktionsverlaufes beider Organe. Die Ventilations-Perfusionsszintigraphie ist hilfreich nach Lungen-Tx bei unilateralen Vorgehen zur Funktionsabschätzung der verbliebenen Eigenlunge, zur Erkennung von Stenosen bzw. der Bronchomalazie im Bereich der Anastomose. Die 3-Phasen-Skelettszintigraphie kann Prognoseparameter nach Knochen-Tx liefern. Weitere, allgemeine Verfahren z. B. zur Messung der Perfusion, des Glukoseoder Fettstoffwechsels, zur Darstellung einer Abstoßungsreaktion, zur Abszeßoder zur Tumorrezidivdiagnostik werden fakultativ eingesetzt.

Summary

Nuclear medicine procedures have special indications in the follow-up of transplanted patients: In case of renal transplantation perfusion, function (glomerular filtration) and urinary flow measured by bolus application of 99mTc-DTPA is an important tool to detect and monitor acute tubular necrosis, rejection, urinary leakage, obstruction or vascular complications. This method is used for pancreatic grafts, too. To exclude rejection in case of heart transplantation more than one year after operation the antimyosin antibody scintigraphy is introduced avoiding biopsies. The radionuclide ventriculography is able to monitor heart function by determining the ejection fraction. Cholescintigraphy in liver transplants is sensitive to detect complications of bile flow. In case of an auxiliary liver transplantation a competition between two livers has been described. This method allows a distinction of functional performance of donor and recipient liver. The same problem is solved by ventilation-perfusion scan in lung transplants. Bone scintigraphy is of prognostic value for graft viability. Other radionuclide examinations have been developed to measure perfusion, glucose-, fat-metabolism to detect rejection episodes, abscesses or tumor recurrencies.

Schlüsselwörter

Transplantation - Nieren- - Leber- - Herz- - Lungen- - Pankreas- - Knochen-Szintigraphie

Key words

Transplantation - renal- - liver- - heart- - lung- - pancras- - bone-scintigraphy

* Herrn Prof. Dr. med. Dr. h. c. H. Hundeshagen zum 65. Geburtstag


Vortrag R 15, DGN, 31. Internationale Jahrestagung, 15. - 17. April 1993 in Köln


 

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