Date: Monday, June 4, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background: Antibody-mediated rejection (AMR) is now the most principal post-surgical complication complicating allograft long-term survival. Therefore, its early detection before serum creatinine rises/estimated glomerular filtration rate decrease serves to timely management and thus improved outcome. 3D-arterial spin labeling(3D-ASL) is a functional magnetic resonance imaging modality that could noninvasively quantify renal allograft cortical perfusion(RACP).
Methods; A total of 109 kidney transplant recipients scheduled for allograft biopsy were prospectively enrolled to undergo magnetic resonance 3D-ASL in a 3.0 Tesla clinical imager. 3D-ASL parameter were measured manually using Functool software package by a nephrologist without knowledge of biopsy results. Allograft biopsy were interpreted according to 2015 Banff schema by an experienced pathologist blinded to MR results.
Results: Data from 6 patients with de novo DSA but noraml biopsy findings(Group A), 8 patients with biopsy-proven subclinical AMR (Group B) and 17 patients with biopsy-proven clinically conspicuous AMR (Group B) were analyzed and compared. Another group comprising 9 patients with biopsy-proven normal allograft served as control group (Group D). RACP as quantified by 3D-ASL was statistically not different between Group D and Group A (238.22ml/100g/min VS 211.30 ml/100g/min,P=0.225) . Combining Group D and Group A as new normal control group (Group E), we observed that decreased RACP in subclinical AMR and more prominently decreased RACP in clinically conspicuous AMR when compared to Group E (114.46 ml/100g/min in subclinical AMR VS 89.74 ml/100g/min in clinically conspicuous AMR VS 227.45 ml/100g/min in Group E, P=0.000) . Using 161.7 ml/100g/min as cutoff criterion, the diagnostic performance for differentiating subclinical AMR from normal allograft is excellent: sensitivity 100% and specificity 100% . Using this cutoff criterion, the diagnostic performance for differentiating AMR from normal allograft is also excellent: sensitivity 92.0% and specificity 100% .
Conclusion: Functional magnetic resonance imaging of 3D-ASL may be used to used as noninvasive method to detect subclinical AMR.
CITATION INFORMATION: Wang W., Wen J., Xu F., Yu Y., Zhang L., Liu Z. Renal Allograft Cortical Perfusion Quantification by 3D-Arterial Spin Labeling Could Be Used to Identify Subclinical Antibody-Mediated Rejection Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Wang W, Wen J, Xu F, Yu Y, Zhang L, Liu Z. Renal Allograft Cortical Perfusion Quantification by 3D-Arterial Spin Labeling Could Be Used to Identify Subclinical Antibody-Mediated Rejection [abstract]. https://atcmeetingabstracts.com/abstract/renal-allograft-cortical-perfusion-quantification-by-3d-arterial-spin-labeling-could-be-used-to-identify-subclinical-antibody-mediated-rejection/. Accessed July 30, 2021.
« Back to 2018 American Transplant Congress