The Detection and Prediction of Acute Rejection Episodes in Human Renal Transplants using Radioactive Fibrinogen1

Abstract

Summary The results of the use of 1251 fibrinogen in 51 studies performed on 45 patients after renal transplantation are reported. The control patients did not show increased transplant radioactivity and there was no significant difference between the clearance slopes of the heart and transplant sites. All 24 studies of acute rejection episodes within the first 50 days after transplantation showed increased transplant radioactivity with a significant difference between 1251 fibrinogen clearance slopes of the heart and transplant sites. Rejection episodes were predicted in 12 patients before clinical and biochemical evidence of rejection. There were no positive results with rejection episodes occurring more than 50 days after transplantation. False positive results were obtained with haematomata, urinary leak, malakoplakia and during ancrod therapy, although in some cases these can be recognised by examination of the clearance slopes. The technique is a useful aid in the diagnosis of acute rejection episodes in transplants within 50 days of the operation but not in chronic rejection.