Klinisch I - P06 - Is it clinically relevant to perform a protocol MAG3 scan post­ope­rative?: A retrospective monocentric study

B. Schmitjes, A. van der Zande, M.W.F. van den Hoogen

Chair(s): prof. dr. Hans de Frijter, neuroloog, LUMC

Thursday 10 march 2016

13:00 - 13:30h at Foyer

Categories: Postersessie

Parallel session: Postersessies XI - Opgesplitst in 3 tijdblokken en 3 categoriëen (klinisch, basaal, donatie)

Objective:
A MAG3 scan can aid in renal transplant patient care if kidney dysfunction develops, but the value of a protocol MAG3 scan is unknown. We evaluated the clinical relevance of a protocol MAG3 scan one day after transplantation.

Methods:
We performed a retrospective, single-center, case study including all patients who underwent renal transplantation between January 2013 and January 2015.

Results:
In our cohort of 396 patients, 177 patients had an abnormal MAG3 scan. In 31 patients the result of the MAG3 scan led to a change in clinical care, including a change in medication in five patients, further diagnostic test in 17 patients and an intervention in six patients. In three patients the protocol MAG3 scan showed urinary leakage, but only in one was this clinically silent. Of the five patients that showed (partial) renal infarction on the protocol MAG3 scan, three had normal perfusion after additional testing. All detected perfusion defects were small. Patients with an abnormal MAG3 scan had significantly older donors (56.1 ± 14.3 yr vs 50.0 ± 15.1 yr; p<0.01) more often a postmortal donor (58.7% vs. 11.8%; p<0.01) and longer warm ischemia time (23.5 ± 7.8 min vs. 20.5 ± 6.7 min; p<0.01). Despite these significant differences, considerable overlap existed in these characteristics.

Conclusion:
In 31 of 396 patients, the protocol MAG3 scan led to a change in renal transplant patient care. Despite significant differences in donor age, donor type and warm ischemia time between patients with a normal or abnormal MAG3 scan, no cut-off point in these characteristics could be found to limit this per protocol strategy. The value of a protocol MAG3 scan seems limited.