John E. Codd

67Ga Citrate in Renal Allograft Rejection

Eight renal allograft recipients were examined on 31 occasions following administration of 99mTc sulfur colloid and 67Ga citrate. Transplant accumulation of each agent was compared and collated with the clinical diagnosis. The procedures matched in 25 instances (81%). Gallium accumulated in the graft producing a false positive result in 2 instances of acute tubular necrosis with anuria, and failed to accumulate within the graft in one case of chronic rejection and in 2 instances of acute rejection. Both radioagents failed to accumulate in 3 patients with acute rejection following heparin therapy. These data indicate that 99mTc sulfur colloid is superior to 67Ga citrate in establishing the diagnosis of transplant rejection and also provides more timely information.

Further Evaluation of 99mTc Sulfur Colloid Accumulation in Rejecting Renal Transplants in Man and a Canine Model1

Renal transplant accumulation of 99m-Tc sulfur colloid was evaluated in 41 patients. Ninety-five examinations were performed comparing transplant with bone marrow activity and clinical or pathological diagnosis. 99m-Tc sulfur colloid accumulated in acute or chronic rejection as long as the vascular supply of the grafted kidney was not severely impaired. Accumulation was marked in chronic rejection, slight in acute rejection and absent in normally functioning transplants or in those with acute tubular necrosis. In the 10 dog models, no accumulation was seen in autografted transplants and early accumulation was demonstrated within the hyperacutely rejecting kidneys of allografted dogs.

The effect of ATP-MgCl2 and dipyridamole pretreatment in renal preservation

Abstract The effect of ATP-MgCl 2 alone and in combination with dipyridamole administered prior to ischemia and cold-storage preservation was evaluated in canine kidneys. Fifteen adult mongrel dogs were divided into three groups. All dogs underwent left nephrectomy and 30 min of in situ warm ischemia followed by Collins C-4 flush and 24 hr of cold-storage preservation. Heterotopic allotransplantation and delayed (2 weeks) contralateral nephrectomy were performed in all dogs. Group A served as ischemic controls. Group B dogs were treated with intravenous ATP-MgCl 2 (2.5 m M ) and Group C dogs with intravenous ATP-MgCl 2 (2.5 m M ) and dipyridamole (10 mg) administered 10 min prior to the ischemic insult. All kidneys underwent cortical biopsies at 0, 4, and 24 hr of preservation for determination of ATP. Mean values for cortical ATP (μmole/g) were 0.165 ± 0.062, 0.046 ± 0.013 and 0.015 ± 0.007 in Group A, 1.101 ± 0.429, 0.352 ± 0.110, and 0.077 ± 0.033 in Group B and 2.296 ± 0.888, 0.496 ± 0.174 and 0.192 ± 0.064 in Group C. The cortical ATP levels were significantly greater at all time intervals in the kidneys pretreated with ATP-MgCl 2 and dipyridamole; however, no significant difference could be demonstrated in dog survival, peak, or final serum creatinine in the three groups. In conclusion, pretreatment with ATP-MgCl 2 with or without dipyridamole does not improve graft function in ischemically injured kidneys.