Evaluating the Transplanted Liver's Condition Based on Scintigraphy Data, Laboratory Results and Biopsy Studies

Abstract

urpose. To identify the data compliance of scintigraphy of the reticuloendothelial system (SRES) with 99mTc-technefit to the results of laboratory and biopsy studies (BS) in patients with transplanted liver. Materials and methods. A total of 75 patients were examined after orthotopic liver transplantation, who underwent scintigraphy of the reticuloendothelial system (SRES), liver biopsy, clinical and biochemical blood analysis, coagulogram, and the level of tacrolimus was determined.Results and discussion. When compared with the results of the biopsy, a strong correlation was established between radionuclide indicators and the activity of hepatitis according to Knodellthe percentage capture of the left lobe of the liver -LL% (r=-0.91) and the specific capture of the liver -SLUwb (r=-0.75). The degree of acute cellular rejection (ACR) according to the results of biopsy demonstrated a strong direct correlation with the percentage of capture of radiopharmaceutical by bone marrow (BM%, r=0.82) and spleen (S%, r=0.78). An inverse strong correlation was noted between the activity of ACR and accumulation in the liver from the whole body -SLUwb%, r=-0.75. From the biochemical parameters with the degree of severity of inflammation in the portal tracts, a strong direct correlation of total bilirubin indicators due to both fractions (r= 0.83) was determined, which is associated with damage to hepatocytes and disruption of bile outflow. An inverse relationship was found between the intensity of inflammation in the portal tracts and the number of platelets in peripheral blood (r=0.73); an analogous correlation was also found with the number of lymphocytes (r=-0.73), probably associated with increased consumption of blood cells by the vascular endothelium and toxic effects on the bone marrow of the therapy. Conclusions.1. Informative and reliable parameters (p<0.05) have been established for an objective evaluation of reticuloendothelial system cell function and the extent of portal hypertension post-organ transplantation. These parameters correlate with liver biopsy data and include the percentage capture of the left lobe of the liver (LL%), liver capture from the whole body (WB%), and specific liver capture from the whole body (SLUwb).2. The high reproducibility of the radionuclide method enables us to recommend it for an objective evaluation of liver function and for dynamic monitoring of the liver's functional state after transplantation, especially in cases with minimal and low histological activity index. Keywords: scintigraphy of the transplanted liver, reticuloendothelial system after liver transplantation, comparison of scintigraphy data and biopsy of the transplanted liver.