Evaluation of renal vascular anatomy in live renal donors: Role of multi detector computed tomography

Abstract

Background:Evaluation of renal vascular variations is important in renal donors to avoid vascular complications during surgery. Venous variations, mainly resulting from the errors of the embryological development, are frequently observed.Aim:This retrospective cross-sectional study aimed to investigate the renal vascular variants with multidetector computed tomography (MDCT) angiography to provide valuable information for surgery and its correlations with surgical findings.Materials and Methods:A total of 200 patients underwent MDCT angiography as a routine work up for live renal donors. The number, course, and drainage patterns of the renal veins were retrospectively observed from the scans. Anomalies of renal veins and inferior vena cava (IVC) were recorded and classified. Multiplanar reformations (MPRs), maximum intensity projections, and volume rendering were used for analysis. The results obtained were correlated surgically.Results:In the present study, out of 200 healthy donors, the standard pattern of drainage of renal veins was observed in only 67% of donors on the right side and 92% of donors on the left side. Supernumerary renal veins in the form of dual and triple renal veins were seen on the right side in about 32.5% of donors (dual right renal veins in 30.5% cases and triple right renal veins in 2.5% cases). Variations on the left side were classified into four groups: supernumerary, retro-aortic, circumaortic, and plexiform left renal veins in 1%, 2.5%, 4%, 0.5%, cases respectively.Conclusions:Developmental variations in renal veins can be easily detected on computed tomography scan, which can go unnoticed and can pose a fatal threat during major surgeries such as donor nephrectomies in otherwise healthy donors if undiagnosed.

Safety and Intraoperative Results in Live Kidney Donors with Vascular Multiplicity After Hand-Assisted Laparoscopy Living Donor Nephrectomy

“…The incidence of supernumerary renal veins varies but is frequently seen more on the right side. 31 Our study revealed 16.1% of donors on the right side and 3.8% on the left side. During nephrectomy, the vein is sacrificed when venous drainage of the smaller vein is <20%.…”

Hand-assisted laparoscopic nephrectomy in a high risk overweight donor with left-sided IVC, and previous abdominal surgery

“…Renal vascular anomalies are rare, but if unexpected may represent an important concern in candidates for living kidney donation given its potential for donor and organ damage (vascular injury) in unexperienced hands. Hence, preoperative assessment of pertinent vascular anatomy by means of high resolution cross-sectional imaging is crucial to avoid potential complications, resulting advisable in every potential candidate to better select the most appropriate operation strategy [13].…”

Vascular Variations of the Kidneys: Case Report and Mini Review

“…easily detected on computed tomography scans, so that fatal threats during major surgeries such as donor nephrectomies in otherwise healthy donors to be avoided [11].…”