Kidney allografts and remaining contralateral donor kidneys before and after transplantation: Assessment by quantitative ^99mTc-DMSA SPECT

We used ^99mTc-dimercaptosuccinic acid (DMSA) quantitative SPECT (QDMSA) to assess the function of kidneys before harvesting and after transplantation as well as the function of remaining donor kidneys. Methods: Nineteen kidney donors underwent a baseline QDMSA study before nephrectomy. The allografts of these kidneys were studied in recipients at 1 wk, 1-2 mo, and 6-15 mo after transplantation. The kidneys remaining in 16 donors were studied at 1-2 mo and 6-15 mo after harvesting. The parameters obtained in each SPECT study included functional volume, concentration of ^99mTc-DMSA per cubic centimeter of renal tissue, and total kidney uptake. Clinical evaluation and determination of serum creatinine levels took place at the same time as SPECT. Results: On the basis of the clinical evaluation, 14 grafts had normal function and 5 were impaired. The mean ± SD of kidney uptake values expressed as percentage of baseline values were 131% ± 30% in normal grafts versus 57% ± 5% in impaired grafts at 1 wk (P < 0.01), 173% ± 57% versus 65% ± 10% at 1-2 mo (P < 0.001), and 190% ± 50% versus 69% ± 14% at 6-15 mo after transplantation (P < 0.01). Uptake values in the donors' remaining kidneys were 159% ± 27% of baseline values at 1-2 mo and 164% ± 30% at 6-15 mo after nephrectomy. Allografts and remaining kidneys showed a similar increase in total kidney uptake as a result of an increase in both functional volume and concentration. Conclusion: QDMSA may be a noninvasive assessment tool in kidney transplantation from living donors.