A MATHEMATICAL MODEL FOR RENAL TRANSPLANT EVALUATION

ALTHOUG RENAL TRANSPLANTATION HAS PROVED TO BE BOTH USEFUL AND COST-EFFECTIVE COMPARED TO DIALYSIS, COMPLICATIONS ARE FREQUENT. MUST OF THE SUCCESS OF RENAL TRANSPLANTATION IS DEPENDENT UPON PROMPT IDENTIFICATION OF THE CAUSE OF IMPAIRMENT OF FUNCTION SO THAT APPROPRIATE TREATMENT CAN BE APPLIED BEFORE THE CONDITION BECOMES IRREVERSIBLE. ALTHOUGH NUCLEAR MEDICINE SYSTEMS AND SEVERAL METHODS OF ANALYSIS ARE AVILABLE TO EVALUATE KIDNEY FUNTION, CURRENTLY NO EVALUATION SYSTEM EXISTS WHICH COMBINES INFORMATION FROM ALL SEGMENTS OF THE TIME-ACTIVITY CURVE TO PROVIDE A GLOBAL ASSESSMENT OF RENAL FUNCTION. AN IMPROVED MEANS OF RADIONUCLIDE RENOGRAM ANALYSIS WOULD CONTRIBUTE TO EARLIER DIAGNOSIS, IMPROVED ACCURACY OF DIAGNOSIS, AND REDUCED NEED FOR BIOPSIES, AN AUTOMATED PROGRAM WOULD SAVE TECHNOLOGISTS TIME AND, THEREBY, MAKE DETAIL ANALYSIS PRACTICABLE; PRESENTING RESULTS AS PROBABILITY OF DIAGNOSIS IN EACH CATEGORY WOULD BE VERY HELPFUL TO CLINICIANS AND WOULD MAKE THE DEGREE OF ASSURANCE OF THE DIAGNOSIS CLEAR; FROM THIS SORT OF PRESENTATION RATIONAL CRITERIA FOR DOING BIOPSIES SHOULD EVOLVE. WE WILL DEVELOP AND EVALUATE A COMPREHENSIVE MATHEMATICAL, PHYSIOLOGIC MODEL WHICH WILL INCLUDE ALL PHASES OF THE TIME-ACTIVITY CURVE IN PERFORMING A GLOBAL ANALYSIS OF RENAL FUNCTION. COEFFICIENTS WILL BE DERIVED REPRESENTING RATE AND CONCENTRATION DATA CORRESPONDING TO THE TRANSIT OF THE TRACER THROUGH THE VARIOUS COMPARTMENTS OF THE KIDNEY. THESE COEFFICIENTS WILL BE CORRELATED WITH THE DIAGNOSES OF INDIVIDUAL CASES. SOFTWARE WILL BE DEVELOPED IN SUCH A WAY THAT IT SHOULD BE APPLICABLE TO THE USUAL NUCLEAR MEDICINE COMPUTERS OR TO THE WORK STATIONS LINKED TO THEM. THUS, IF SUCCESSFUL, THE PRODUCT SHOULD BE WIDELY APPLICABLE TO ANY FACILITY WITH A RENAL TRANSPLANT PROGRAM DESIRING ANALYTICAL TREATMENT OF RADIONUCLIDE TRANSPLANT EVALUATIONS.