Objectives To evaluate the relationship between early postoperative mercaptoacetyltriglycine (MAG3) renal scintigraphy findings and short‐term graft function after kidney transplantation and to assess the necessity of routine postoperative day (POD)–1 imaging. Patients and Methods We retrospectively analyzed 67 living‐donor kidney transplantation recipients who underwent MAG3 scintigraphy on POD‐1, 8, and 15 between January 2007 and April 2024. Renogram curve patterns were classified as normal, reduced excretion, or hypofunctional based on T 1/2 values. Effective renal plasma flow (ERPF) was also recorded. Associations between renogram type/ERPF and graft function within 3 months were evaluated, and acute rejection events were documented. Results On POD‐1, renogram types were normal in 16 patients, reduced excretion in 13, and hypofunctional in 38; on POD‐8, the corresponding numbers were 39, 6, and 22; and on POD‐15, they were 33, 9, and 25, respectively. Regardless of POD‐1 renogram type, serum creatinine and estimated glomerular filtration rate reached to ≤ 2.0 mg/dL and ≥ 40 mL/min/1.73 m 2 within 3 months. No significant differences in renal function at 3 months were observed among renogram types at any time point. ERPFs on POD‐1, 8, and 15 were strongly correlated. Graft function showed a similar course across ERPF levels. Acute rejection occurred in two patients within 3 months, neither predicted by scintigraphy. Conclusions Early graft function improved similarly across all renogram types and ERPF levels. Because routine POD‐1 imaging has limited prognostic value, we propose replacing the routine multiple‐scan protocol with a single baseline scan performed once the patient is hemodynamically stable. Subsequent imaging should be strictly indication‐based, optimizing diagnostic utility while minimizing patient burden.
Makino et al. (Thu,) studied this question.