Using 18FDG PETCT Scans to Detect and Manage Hidden Kidney Transplant Rejection and Guide Steroid Withdrawal

What this Trial Is About

Researchers are investigating non-invasive methods to diagnose and manage subclinical acute rejection in kidney transplant patients. The study focuses on comparing the use of 18-fluoro-deoxy-glucose positron emission tomography combined with computed tomography 18FDG PETCT with the standard renal biopsy performed approximately three months after transplantation. This approach aims to reduce the need for invasive biopsies and support decisions on corticosteroid withdrawal by detecting metabolic activity indicative of rejection. Participants undergo 18FDG PETCT imaging on the day of their scheduled surveillance biopsy. Based on biopsy and PETCT results, patients are categorized into three groups those with humoral rejection receive standard treatment and exit the study those without humoral rejection but with high metabolic activity on PETCT also continue standard care and those without humoral rejection and low metabolic activity have their corticosteroid treatment gradually reduced. Throughout the study, kidney transplant patients receive regular assessments including histological analysis of biopsy samples by blinded pathologists and PETCT imaging with standardized procedures. Researchers measure metabolic activity ratios and track outcomes such as prediction of rejection at three months and corticosteroid withdrawal at six months. Follow-up includes monitoring graft rejection at six months and one year, providing comprehensive data on the safety and utility of PETCT in managing subclinical rejection.

Added Value of 18 FDG Pet-scanner in Diagnosis and Management of Subclinical Rejection in Kidney Transplant Patients