Actually more than 80% of heart recipients survive the first postoperative year. Early death is mainly caused by rejection and acute infection. After the first year progressive graft atherosclerosis has the greatest impact on prognosis. The review presents scintigraphic methods that have reached clinical impact in the diagnosis of rejection and vascular complications. Immunoscintigraphy with 111In-labelled monoclonal antibodies against myosin proved to be of importance in the diagnosis of rejection especially in long-term follow-up. Perfusion scintigraphy reveals vital and ischemic myocardium. In heart transplant recipients radionuclide ventriculography has been widely replaced by echocardiography. Up to now, the evaluation of increasing nerval integration with 123I-MIBG has not reached clinical impact.
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