Evaluation of myocardial perfusion and function after kidney transplantation by Gated SPECT myocardial perfusion scintigraphy

Introduction: The aim of this study was to evaluate the effect of successful kidney transplantation (KT) on myocardial perfusion and left ventricular function by both qualitative (visual) interpretation and semiquantitative parameters, using myocardial perfusion scintigraphy with gated-single photon emission computed tomography (gated-SPECT) in patients suffering from end-stage renal disease. Methods: From a total of 38 patients who were candidates of KT, twenty-six patients (16 female, 10 male, mean age: 47.5 yr, range: 24-64 yr) who had successful KT were included. Myocardial perfusion scintigraphy was performed by Gated Single Photon Emission Computed Tomography (Gated-SPECT) method, before and after surgery (mean: 24 months).  Perfusion and function status was evaluated by qualitative and semiquantitative parameters. Results: Our data showed qualitative evidence of perfusion and functional abnormality in pre-transplant scans as follows: Abnormal perfusion in left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA) territories in 42.5%, 53.8% and 65.4% of cases, respectively; dilation in 57.7% and inhomogenity of uptake in 53.8% of cases. However no statistically significant change was noted after transplantation, i.e. p value for all semiquantitative values including summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS), summed motion score (SMS), summed thickening score (STS), ejection fraction (EF), end diastolic volume (EDV), end systolic volume (ESV), and stroke volume (SV)  was greater than 0.05. Conclusion: Renal transplantation may not have considerable long term effect on myocardial perfusion and function in patients with chronic renal failure. This could be due to either non-reversible myocardial changes or continuing effect of degrading factors on the myocardium.

Keywords:

Kidney transplantation , Myocardial perfusion , Myocardial function , Gated-SPECT