Alterations of the Blood Pool in the Femoral Head Before and After Renal Transplantation

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Objective : The pathogenesis of idiopathic osteonecrosis of the femoral head (ION) is thought to be an ischemic event. The purpose of this study is to investigate alterations of the blood pool in the femoral head before and after renal transplantation.<BR>Methods : After renal transplantion, all patients received the same immunosuppressive therapy : corticosteroids, cyclosporin-A, and azathioprine. We performed 3-phase bone scintigraphy on 16 renal allograf t recipients within 1 week before renal transplantation, and between week 4 and 9 after renal transplantation. Regions of interest (ROI) were assigned bilaterally in the femoral head, diaphysis, and soft tissue. The head-to-diaphysis ratios (HD ratios) were then calculated.<BR>Results : Idiopathic osteonecrosis of the femoral head occurred in 2 femoral heads of 1 patient. The HD ratio before renal transplantation (mean HD +/- SD, 1.52 +/- 0.30) and the HD ratio after renal transplantion (1.28 +/- 0.30) were significantly different (P=0.000024) .<BR>Discussion and Conclusion : The HD ratios before and after renal transplantation were significantly different, indicating that the administration of steroids diminished the blood pool in the femoral head. A low HD ratio before renal transplantion revealed a poor blood pool in the femoral head, which may be a risk factor for ION.
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