Serial quantitative 99mTc DTPA imaging in CMV-associated renal allograft dysfunction

Two cases of cytomegalovirus associated renal allograft dysfunction were monitored by serial 99mTc DTPA imaging and cytomegalovirus specific fluorescent antibody tests. One case of primary cytomegalovirus disease associated with pneumonitis, hepatitis and pyrexia occurred 25 days after transplantation. The second case, due to cytomegalovirus reactivation/reinfection had fewer symptoms and occurred 78 days following transplantation. 99mTc DTPA perfusion index at the height of the cytomegalovirus associated illness remained unaltered in both cases, and did not suggest the presence of acute rejection. This non-reactive response was associated with a rapid return of graft function. The combined use of these rapid diagnostic tests during suspected rejection episodes may be useful in indicating cytomegalovirus associated allograft dysfunction and preventing the addition of further potentially harmful immunosuppressants.