期刊
INVESTIGATIVE RADIOLOGY
卷 51, 期 2, 页码 113-120出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/RLI.0000000000000210
关键词
renal function; renal transplant; arterial spin labeling MRI; blood oxygen level-dependent MRI
资金
- NIH/NIDDK [R01 DK073680]
- NIH/NCI Radiological Sciences Training Grant, Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI [5T32 CA009206]
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI
- GE Healthcare
Objectives: The aims of this study were to assess renal function in kidney transplant recipients and their respective donors over 2 years using arterial spin labeling (ASL) and blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) and to prospectively evaluate the effect of losartan on functional MRI measures in recipients. Materials and Methods: The study included 15 matched pairs of renal transplant donors and recipients. Arterial spin labeling and BOLD MRI of the kidneys were performed on donors before transplant surgery (baseline) and on both donors and recipients at 3 months, 1 year, and 2 years after transplant. After 3 months, 7 of the 15 recipients were prescribed 25 to 50 mg/d losartan for the remainder of the study. A linear mixed-effects model was used to evaluate perfusion, R-2*, estimated glomerular filtration rate, and fractional excretion of sodium for changes across time or associated with losartan treatment. Results: In donors, cortical perfusion in the remaining kidney decreased by 50 +/- 19mL/min per 100g (11.8%) between baseline and 2 years (P<0.05), while cortical R-2* declined modestly by 0.7 +/- 0.3s(-1) (5.6%; P<0.05). In transplanted kidneys, cortical perfusion decreased markedly by 141 +/- 21 mL/min per 100g (34.2%) between baseline and 2 years (P<0.001), while medullary R-2* declined by 1.5 +/- 0.8s(-1) (8.3%; P=0.06). Single-kidney estimated glomerular filtration rate increased between baseline and 2 years by 17.7 +/- 2.7mL/min per 1.73m(2) (40.3%; P<0.0001) in donors and to 14.6 +/- 4.3 mL/min per 1.73m(2) (33.3%; P<0.01) in recipients. Cortical perfusion at 1 and 2 years in recipients receiving 25 to 50 mg/d losartan was 62 +/- 24mL/min per 100 g higher than recipients not receiving the drug (P<0.05). No significant effects of losartan were observed for any other markers of renal function. Conclusions: The results suggest an important role for noninvasive functional monitoringwith ASL and BOLDMRI in kidney transplant recipients and donors, and they indicate a potentially beneficial effect of losartan in recipients.
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