Limited clinical value of two consecutive post-transplant renal scintigraphy procedures

Stan Benjamens, Robert A. Pol, Stefan P. Berger, Andor W.J.M. Glaudemans, Petra Dibbets-Schneider, Riemer H.J.A. Slart, Lioe Fee de Geus-Oei

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Abstract

Objectives: Duration of delayed graft function (DGF) and length of hospital stay (LOS) are outcomes of interest in an era that warrants increased efficacy of transplant care whereas renal allografts originate increasingly from marginal donors. While earlier studies investigate the predictive capability of a single renal scintigraphy, this study focuses on the value for both DGF duration and LOS of consecutively performed scintigraphies. Methods: From 2011 to 2014, renal transplant recipients referred for a Tc-99m MAG3 renal scintigraphy were included in a single-center retrospective study. Primary endpoints were DGF duration and LOS. Both the first (≤ 3 days) and second scintigraphies (3–7 days after transplantation) were analyzed using a 4-grade qualitative scale and quantitative indices (TFS, cTER, MUC10, average upslope). Results: We evaluated 200 first and 108 (54%) consecutively performed scintigraphies. The Kaplan-Meier curves for DGF duration and qualitative grading of the first and second scintigraphy showed significant differences between the grades (p < 0.01). The Kaplan-Meier curve for the delta grades between these procedures (lower, equal, or higher grade) did not show significant differences (p = 0.18). Multivariate analysis showed a significant association between the qualitative grades, from the first and second scintigraphy, and DGF duration, HR 1.8 (1.4–2.2, p < 0.01) and 2.8 (1.8–4.3, p < 0.01), respectively. Conclusions: Qualitative grades of single renal scintigraphies, performed within 7 days after transplantation, can be used to make a reliable image-guided decision on the need for dialysis and to predict LOS. A consecutive renal scintigraphy, however, did not show an additional value in the assessment of DGF. Key Points: • Post-transplant renal scintigraphy procedures provide information to predict delayed graft function duration and length of hospital stay. • Performing two consecutive renal scintigraphy procedures within 1 week after transplantation does not strengthen the prediction of delayed graft function duration and length of hospital stay. • Single renal scintigraphy procedures can be used to provide clinicians and patients with a reliable indication of the need for dialysis after transplantation and the expected duration of hospitalization.

Original languageEnglish
Pages (from-to)452-460
JournalEuropean radiology
Volume30
Issue number1
Early online date23 Jul 2019
DOIs
Publication statusE-pub ahead of print/First online - 23 Jul 2019

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Radionuclide Imaging
Delayed Graft Function
Length of Stay
Transplants
Kidney
Transplantation
Dialysis
Allografts
Hospitalization
Multivariate Analysis
Retrospective Studies
Tissue Donors

Keywords

  • UT-Hybrid-D
  • Kidney transplantation
  • Length of stay
  • Radionuclide imaging
  • Delayed graft function

Cite this

Benjamens, Stan ; Pol, Robert A. ; Berger, Stefan P. ; Glaudemans, Andor W.J.M. ; Dibbets-Schneider, Petra ; Slart, Riemer H.J.A. ; de Geus-Oei, Lioe Fee. / Limited clinical value of two consecutive post-transplant renal scintigraphy procedures. In: European radiology. 2020 ; Vol. 30, No. 1. pp. 452-460.
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abstract = "Objectives: Duration of delayed graft function (DGF) and length of hospital stay (LOS) are outcomes of interest in an era that warrants increased efficacy of transplant care whereas renal allografts originate increasingly from marginal donors. While earlier studies investigate the predictive capability of a single renal scintigraphy, this study focuses on the value for both DGF duration and LOS of consecutively performed scintigraphies. Methods: From 2011 to 2014, renal transplant recipients referred for a Tc-99m MAG3 renal scintigraphy were included in a single-center retrospective study. Primary endpoints were DGF duration and LOS. Both the first (≤ 3 days) and second scintigraphies (3–7 days after transplantation) were analyzed using a 4-grade qualitative scale and quantitative indices (TFS, cTER, MUC10, average upslope). Results: We evaluated 200 first and 108 (54{\%}) consecutively performed scintigraphies. The Kaplan-Meier curves for DGF duration and qualitative grading of the first and second scintigraphy showed significant differences between the grades (p < 0.01). The Kaplan-Meier curve for the delta grades between these procedures (lower, equal, or higher grade) did not show significant differences (p = 0.18). Multivariate analysis showed a significant association between the qualitative grades, from the first and second scintigraphy, and DGF duration, HR 1.8 (1.4–2.2, p < 0.01) and 2.8 (1.8–4.3, p < 0.01), respectively. Conclusions: Qualitative grades of single renal scintigraphies, performed within 7 days after transplantation, can be used to make a reliable image-guided decision on the need for dialysis and to predict LOS. A consecutive renal scintigraphy, however, did not show an additional value in the assessment of DGF. Key Points: • Post-transplant renal scintigraphy procedures provide information to predict delayed graft function duration and length of hospital stay. • Performing two consecutive renal scintigraphy procedures within 1 week after transplantation does not strengthen the prediction of delayed graft function duration and length of hospital stay. • Single renal scintigraphy procedures can be used to provide clinicians and patients with a reliable indication of the need for dialysis after transplantation and the expected duration of hospitalization.",
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author = "Stan Benjamens and Pol, {Robert A.} and Berger, {Stefan P.} and Glaudemans, {Andor W.J.M.} and Petra Dibbets-Schneider and Slart, {Riemer H.J.A.} and {de Geus-Oei}, {Lioe Fee}",
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Limited clinical value of two consecutive post-transplant renal scintigraphy procedures. / Benjamens, Stan; Pol, Robert A.; Berger, Stefan P.; Glaudemans, Andor W.J.M.; Dibbets-Schneider, Petra; Slart, Riemer H.J.A.; de Geus-Oei, Lioe Fee.

In: European radiology, Vol. 30, No. 1, 01.01.2020, p. 452-460.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Limited clinical value of two consecutive post-transplant renal scintigraphy procedures

AU - Benjamens, Stan

AU - Pol, Robert A.

AU - Berger, Stefan P.

AU - Glaudemans, Andor W.J.M.

AU - Dibbets-Schneider, Petra

AU - Slart, Riemer H.J.A.

AU - de Geus-Oei, Lioe Fee

N1 - Springer deal

PY - 2019/7/23

Y1 - 2019/7/23

N2 - Objectives: Duration of delayed graft function (DGF) and length of hospital stay (LOS) are outcomes of interest in an era that warrants increased efficacy of transplant care whereas renal allografts originate increasingly from marginal donors. While earlier studies investigate the predictive capability of a single renal scintigraphy, this study focuses on the value for both DGF duration and LOS of consecutively performed scintigraphies. Methods: From 2011 to 2014, renal transplant recipients referred for a Tc-99m MAG3 renal scintigraphy were included in a single-center retrospective study. Primary endpoints were DGF duration and LOS. Both the first (≤ 3 days) and second scintigraphies (3–7 days after transplantation) were analyzed using a 4-grade qualitative scale and quantitative indices (TFS, cTER, MUC10, average upslope). Results: We evaluated 200 first and 108 (54%) consecutively performed scintigraphies. The Kaplan-Meier curves for DGF duration and qualitative grading of the first and second scintigraphy showed significant differences between the grades (p < 0.01). The Kaplan-Meier curve for the delta grades between these procedures (lower, equal, or higher grade) did not show significant differences (p = 0.18). Multivariate analysis showed a significant association between the qualitative grades, from the first and second scintigraphy, and DGF duration, HR 1.8 (1.4–2.2, p < 0.01) and 2.8 (1.8–4.3, p < 0.01), respectively. Conclusions: Qualitative grades of single renal scintigraphies, performed within 7 days after transplantation, can be used to make a reliable image-guided decision on the need for dialysis and to predict LOS. A consecutive renal scintigraphy, however, did not show an additional value in the assessment of DGF. Key Points: • Post-transplant renal scintigraphy procedures provide information to predict delayed graft function duration and length of hospital stay. • Performing two consecutive renal scintigraphy procedures within 1 week after transplantation does not strengthen the prediction of delayed graft function duration and length of hospital stay. • Single renal scintigraphy procedures can be used to provide clinicians and patients with a reliable indication of the need for dialysis after transplantation and the expected duration of hospitalization.

AB - Objectives: Duration of delayed graft function (DGF) and length of hospital stay (LOS) are outcomes of interest in an era that warrants increased efficacy of transplant care whereas renal allografts originate increasingly from marginal donors. While earlier studies investigate the predictive capability of a single renal scintigraphy, this study focuses on the value for both DGF duration and LOS of consecutively performed scintigraphies. Methods: From 2011 to 2014, renal transplant recipients referred for a Tc-99m MAG3 renal scintigraphy were included in a single-center retrospective study. Primary endpoints were DGF duration and LOS. Both the first (≤ 3 days) and second scintigraphies (3–7 days after transplantation) were analyzed using a 4-grade qualitative scale and quantitative indices (TFS, cTER, MUC10, average upslope). Results: We evaluated 200 first and 108 (54%) consecutively performed scintigraphies. The Kaplan-Meier curves for DGF duration and qualitative grading of the first and second scintigraphy showed significant differences between the grades (p < 0.01). The Kaplan-Meier curve for the delta grades between these procedures (lower, equal, or higher grade) did not show significant differences (p = 0.18). Multivariate analysis showed a significant association between the qualitative grades, from the first and second scintigraphy, and DGF duration, HR 1.8 (1.4–2.2, p < 0.01) and 2.8 (1.8–4.3, p < 0.01), respectively. Conclusions: Qualitative grades of single renal scintigraphies, performed within 7 days after transplantation, can be used to make a reliable image-guided decision on the need for dialysis and to predict LOS. A consecutive renal scintigraphy, however, did not show an additional value in the assessment of DGF. Key Points: • Post-transplant renal scintigraphy procedures provide information to predict delayed graft function duration and length of hospital stay. • Performing two consecutive renal scintigraphy procedures within 1 week after transplantation does not strengthen the prediction of delayed graft function duration and length of hospital stay. • Single renal scintigraphy procedures can be used to provide clinicians and patients with a reliable indication of the need for dialysis after transplantation and the expected duration of hospitalization.

KW - UT-Hybrid-D

KW - Kidney transplantation

KW - Length of stay

KW - Radionuclide imaging

KW - Delayed graft function

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DO - 10.1007/s00330-019-06334-1

M3 - Article

VL - 30

SP - 452

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JO - European radiology

JF - European radiology

SN - 0938-7994

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Benjamens S, Pol RA, Berger SP, Glaudemans AWJM, Dibbets-Schneider P, Slart RHJA et al. Limited clinical value of two consecutive post-transplant renal scintigraphy procedures. European radiology. 2020 Jan 1;30(1):452-460. https://doi.org/10.1007/s00330-019-06334-1