Radionuclide evaluation of liver transplants

Blood Clearance of ^99mTc-Trimethyl-Br-IDA Discriminates between Different Degrees of Severe Liver Ischaemia – Reperfusion Injury in the Rat

“…The excretion of tracer into the bile canaliculi is thought to occur via active transport. Once excreted, 99mTc-Trimethyl-Br-IDA does not enter the enterohepatic circulation and is thus effectively removed from the system [1,4], The transcellular trans port of this tracer via the organic anion path is characterised by saturation, as suggested by our results (fig. 2).…”

“…This model allows an accurate prediction of the magnitude of liver damage related to the period of ischaemia and is useful to evaluate tests of liver function. Experimental and clinical studies have clearly demonstrated the rapid hepatic uptake and blood disappearance of Tc-HIDA compounds [2,4,21], with a proven hepatic excretion of 98% in the case of 99mTc-Trimcthyl-Br-IDA [9], Following intravenous injection, 99mTc-Trimethyl-Br-IDA is carried to the liver loose ly bound to plasma proteins, mainly albumin. In the space of Disse, dissociation takes place between 99mTc-Trimethyl-Br-IDA and pro teins; the proteins are left behind in the blood, and the tracer enters the hepatocyte via a car rier-mediated non-sodium-dependent organic anion path, by a mechanism very similar to that of bilirubin.…”

In liver transplantation, T tube bile represents total bile flow: Physiological and scintigraphic studies on biliary secretion of organic anions

“…38 However, in liver transplant recipients, this diagnostic regimen has been used only to detect biliary leaks, vascular insufficiency, or infections. [39][40][41][42] Physiological data concerning hepatic uptake and secretory function after transplantation as shown in this study are barely reported. 42 In addition to our physiological data that evaluate mainly the canalicular excretory function of the graft, we now also show impairment of the hepatocellular uptake function of organic anions.…”

“…[39][40][41][42] Physiological data concerning hepatic uptake and secretory function after transplantation as shown in this study are barely reported. 42 In addition to our physiological data that evaluate mainly the canalicular excretory function of the graft, we now also show impairment of the hepatocellular uptake function of organic anions. To our knowledge, it is the first time that time-dependent normalization of a specific hepatocellular process after OLT is described, a function that cannot be studied in patients by other means.…”

Liver transplant rejection and cholestasis: comparison of technetium 99m-diisopropyl iminodiacetic acid hepatobiliary imaging with liver biopsy

“…Biochemical parameters have been shown to be of limited clinical value in the immediate postoperative period (Esquivel et al 1985). Although radionuclide imaging (Brown et al 1986;Hawkins et al 1988;Loken et al 1986), ultrasonography (Dalen et al 1988;Davis et al 1989;Letourneau et al 1987a), computed tomography (Dalen et al 1988;Letourneau et al 1987b), angiography (White et al 1987) and cholangiography (Bauman et al 1989;Zajko et al 1985) have been used in the evaluation of posttransplant complications, liver biopsy remains the gold standard. Loken et al (1986), Brown et al (1986) and Hawkins et al (1988) have shown the value of DISIDA scintigraphy in liver transplant patients with biliary and vascular complications, infections and rejection.…”