Evaluation of the Renal Arteries of 2,144 Living Kidney Donors Using Computed Tomography Angiography and Comparison with Intraoperative Findings

Abstract

Objectives: A carefully chosen and suitably prepared kidney donor is essential in living-donor kidney transplantation. Computed tomography angiography (CTA) is an effective imaging method for evaluating the renovascular morphology of donor candidates. The aim of this study was to evaluate renal artery variations in kidney donors using CTA and compare the findings with the number of arteries detected during laparoscopic donor nephrectomy. Materials and Methods: The study included 2,144 living donors who underwent pretransplant renovascular assessment using CTA and laparoscopic donor nephrectomy in our center between August 2012 and October 2018. The number of renal arteries to the donor kidney detected on CTA was compared with the number of arteries discovered intraoperatively. Results: The mean age of the 2,144 living kidney donors included in the study was 47.19 ± 13.3 (18-87) years. According to CTA findings, 81.1% (n = 1,738) had a single renal artery, 17.2% (n = 369) had double renal arteries, 1.6% (n = 35) had triple renal arteries, and 0.1% (n = 2) had quadruple renal arteries. The same number of renal arteries were detected by CTA and in laparoscopic donor nephrectomy in 97.9% (n = 2,099) of the donors. In the other 2.1% (n = 45), fewer renal arteries were detected intraoperatively compared to their CTA findings. None of the donors included in the study had a greater number of renal arteries discovered during nephrectomy than by CTA. Conclusion: CTA is a highly accurate method for the evaluation of renovascular variations in donor candidates for living-donor kidney transplantation. However, it must be kept in mind that double or multiple renal artery variations may be detected on CTA in 18.9% of donor candidates.

Does a Renal Vascular Variation in the Renal Allograft Determine the Outcome of Renal Transplantation? Experience from the National Kidney Transplantation Center, Ethiopia

“…During the time of organ harvest, it is crucial for the kidney procurement team to consider significant vascular anatomical variations. Grafts with anatomic variations, such as double ureters and multiple renal vessels, present a challenge to transplant surgeons in both living and deceased donor transplants because these vessels are smaller in diameter and anastomosing them is difficult and time consuming, [17][18][19][20][21] resulting in longer warm ischemia time and a higher incidence of delayed graft function.…”

“…Computed tomography angiography is an effective method for evaluating the renovascular morphology of the donor. 20 The purpose of this study was to evaluate the outcomes of transplantation of renal allografts with variant renal vasculature as compared to allografts without renal vascular variation in the national kidney transplantation center of Ethiopia.…”

Laparoscopic Live Donor Nephrectomy: Experience of High-Volume Center with 2,477 Cases

“…Living donor nephrectomy is against the first rule of the medicine, “primum non nocere” [10]. A healthy human’s healthy organ is extracted from him and transplanted to another person.…”

Update on the Management of Urological Problems Following Kidney Transplantation

“…The third approach is the conservative surveillance of stones ≥4 mm. Non-contrast computed tomography has become the gold standard method for visualizing stones in the urinary tract [48]. The higher sensitivity of computed tomography enables the detection of asymptomatic kidney stones <4 mm during the preoperative evaluation of potential kidney donors [41].…”