Ureteral obstruction can be particularly difficult to diagnose and often require a multi-modality approach. Poorly functioning grafts may not show a dilated pelvis. Delayed complications Delayed complications can include lymphoceles, chronic rejection, cyclosporin toxicity, recurrent disease, renal artery stenosis, and ureteral stenosis. Lymphoceles can exert significant pressure effects and cause vascular and ureteral compromise. Although cold regions on scintigrams can represent lymphoceles, scintigrams should not be used for the primary diagnosis of this complication.
Chronic rejection is a slow, irreversible process, and is inadequately understood.
Antirejection drugs are not very effective for this condition. Renal scintigraphy shows decreased perfusion and function, but biopsy is often required for definitive diagnosis. Chronic rejection can often not be differentiated by scintigraphy from cyclosporin toxicity, renal artery stenosis, or ureteral stenosis. Conclusion Scintigraphy can play a vital role in the diagnosis of complications following renal transplantation. Unfortunately, scintigrams are often non-specific.