Urinary reflux to the non-functioning previous renal graft

Document Type : Case Report

Authors

Nuclear Medicine Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Nuclear medicine imaging is routinely used for evaluation of perfusion and function of the transplanted kidneys. At present, the radiopharmaceutical of choice for this study in our center is Tc 99m-Ec. Complications of the kidney graft are demonstrable in the early and delayed images. One of these complications is vesicoureteral reflux to the graft or to the native kidneys. We present a 27 year old patient with elevated BUN and Cr ten days after kidney transplantation. He previously had failed renal transplantation due to rejection. Tc-99m EC renal scan revealed decreased perfusion and function suggesting acute rejection. In the late functional images (at 24 minute), vesicoureteral reflux to the previous non‑functioning graft was also noticed on the right side of the pelvis. We recommend considering vesicouretral reflux while interpreting renal transplant imaging since this can be easily mistaken with other complications such as urine leakage.

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Dubovsky E, Malley J. Evaluation of renal transplants. In: Henkin RE. Nuclear medicine.2nd ed. Philadelphia: Mosby Elsevier; 2006. p. 1063-69.
Praz V, Leisinger HJ, Pascual M, Jichlinski P. Urological complications in renal transplantation from cadaveric donor grafts: a retrospective analysis of 20 years. Urol Int. 2005;75(2):144-9.
Barrero R, Fijo J, Fernandez-Hurtado M, García-Merino F, León E, Torrubia F. Vesicoureteral reflux after kidney transplantation in children. Pediatr Transplant. 2007 Aug;11(5):498-503.
Vianello A, Pignata G, Caldato C, Di Falco G, Calconi G, Fandella A, Rabassini A, Maresca MC. Vesicoureteral reflux after kidney transplantation: clinical significance in the medium to long-term. Clin Nephrol. 1997 Jun;47(6):356-61.
Mastrosimone S, Pignata G, Maresca MC, Calconi G, Rabassini A, Butini R, Fandella A, Di Falco G, Chiara G, Caldato C, et al. Clinical significance of vesicoureteral reflux after kidney transplantation. Clin Nephrol. 1993 Jul;40(1):38-45.
Sadeghi R, Javad A, Zakavi R, Kakhki VR. Vesicoureteral reflux to the non-functional graft on a renal transplant imaging with 99mTc-DTPA. Rev Esp Med Nucl. 2009 Nov-Dec;28(6):305-6.