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Volume: 11 Issue: 6 December 2013 - Supplement - 2

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POSTER PRESENTATION
The Diagnostic Significance of Hepatic Parenchymal Retention Index Parameter Determined By Hepatobiliary Scintigraphy in Liver Transplant Recipients

Introduction: Hepatobiliary scintigraphy with Tc-99m iminodiacetic acid derivatives is a non-invasive, objective, and quantitative technique to evaluate the function and integrity of the hepatobiliary tree in liver transplant recipients. This method easily identifies many structural complications as well as functional complications related to hepatic perfusion, tracer uptake, and excretion. The aim of this study was to evaluate the value of hepatic parenchymal retention index parameter determined by hepatobiliary scintigraphy in the early diagnosis of functional complications in liver transplant recipients.

Materials and Methods: One hundred liver transplant recipients (64men, 36 women of overall mean age 29.12 ± 14.2 years) were studied. Hepatobiliary scintigraphy was performed at 7-10 days after the transplantation immediately after intravenous injection of 1.85 MBq/kg of Tc-99m mebrofenin. A large field-of-view dual-head gamma camera was used for image acquisition. To test graft perfusion data were recorded every one second for one minute, to evaluate parenchymal function, data were recorded every 30 seconds for 40 minutes. The images were evaluated visually and quantitatively. The quantitative parameters used werehepatocyte extraction fraction and hepatic parenchymal retention index. Scintigraphic findings were then correlated with biopsy results.

Results: In the visual analysis, all grafts (100%) showed normal perfusion and normal hepatocyte extraction. In the quantitative analysis, hepatocyte extraction fraction values were within the normal range in all cases (mean value: 96.2 ± 2.3%). According to the results of hepatic parenchymal retention, patients were divided into 3 groups. Group 1 consisted of 75 recipients, in whom hepatocyte excretion was seen as normal. In these patients, hepatic parenchymal retention index values were within the normal range (mean: 18.14± 4.30%). Group 2 included 15 patients, whose liver grafts showed severely decreased hepatocyte excretion. In this group, hepatic parenchymal retention index values elevated severely (mean: 82.64 ± 8.23 %). Group 3 included 10 patients, in whom hepatocyte excretion decreased mildly-moderately and hepatic parenchymal retention index increased mildly-moderately (mean: 43.60 ± 9.80 %). The hepatic parenchymal retention index values were then statistically compared and significant differences were found among these 3 groups (p<0.001). When the scintigraphic findings were compared with biopsy results, it was revealed that acute rejection in all Group 2 recipients and mild-moderate hepatocyte damage/cholestasis in all Group 3 patients.

Conclusions: In the light of these findings, we conclude that, hepatic parenchymal retention index parameter determined by hepatobiliary scintigraphy may be valuable in the early diagnosis of functional complications in liver transplant recipients.



Volume : 11
Issue : 6
Pages : 62


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