IIDA Takashi Tokai University School of Medicine, Transplantation I Assistant researcher, 医学部・移植学教室I, 助手 (10193137)
KITAMURA Makoto Tokai university School of Medicine, Transplantation I Assistant Professor, 医学部・移植学教室I, 講師 (00214817)
HIDA Miho Tokai University School of Medicine, Transplantation I Associate Professor, 医学部・移植学教室I, 助教授 (20147169)
KAKUTA Takatoshi Tokai University School of Medicine, Transplantation I Assistant researcher, 医学部・移植学教室I, 助手 (50276854)
|Budget Amount *help
¥1,800,000 (Direct Cost : ¥1,800,000)
Fiscal Year 1995 : ¥500,000 (Direct Cost : ¥500,000)
Fiscal Year 1994 : ¥1,300,000 (Direct Cost : ¥1,300,000)
An uptake coefficient (UC), proportional to glomerular filtration ratio (GFR), can be calculated from renal dynamic images with Tc-99m DTPA applying Rutland graphic method. In this novel method, the accurate measurement of UC is necessary with the utilization of input and output functions obtained under an uniform geometric and temporal condition. Therefore, we developed a novel method of extracting input and output functions as UCs, applying factor analysis method to renal dynamic images with Tc-99m DTPA.Results of basic study obtained from phantom experiments constructed with blood purification equipments, and results obtained from clinical one in renal transplant donors and recipients are presented.
The phantom was consisted of the followiing 5 components ; a heart (main pump), an abdominal aorta (AA), a renal artery (RA), an intrarenal artery (IRA), and glomeruli (reservoir) in changeable GFR.UCs were computed responding to different input function on AA, RA and IRA, and the combine
d function of IRA and reservoir was estimated as an output function between each different GFRs setting within 3% error ranges. The experiments were repeated twice in the same protocol. UCs revealed the most accurately estimated when IRAs were utilized as an input functions. Dynamic renal images were obtained in 22 recipients with renal graft, 11 donors, 3 patients of acute renal failure and 8 adults as a control group. Serial renal images at 10 seconds interval were obtained after intravenous bolus injection of 600MBq of Tc-99m DTPA.Three factors, renal blood flow factor (factor 1), parenchymal uptake factor (factor 2) and excretory factor (factor 3), were extracted from the dynamic renal image by applying factor analyzes methhod. Finally, UCs were computed by regarding factor 1 and Factor 2 as an input and an output function, respectively. UCs proved to have good correlation with creatinine clearance in normal controls and in renal allografts. The median UCs in post transplantation decreased to 87.5% in renal transplant recipients, however, three cases showed increased UC.The median UCs of contralateral kidneys in 11 donors increased from 0.3 in pretransplantation to 0.46 at 3 weeks after transplantation.
The accuracy of the newly developed method for estimating GFR was confirmed by phantom experimental modules. UCs computed by our novel method showed to have a good correlation with creatinine clearance in the normal subjects in and allografts. UCs, the new index of renal function are very useful for following up the graft function of recipients as well as contralateral renal function of donors.
2)腎移植者と正常位置に2腎を有するものでは,Factor UCとCcrには,同様の相関関係があるものの,それぞれ異なったClusterを形成した事から,その病態を反映しているものと考えられた. Less