Preoperative evaluation of living kidney donors using multirow detector computed tomography: comparison with digital subtraction angiography and intraoperative findings

Hänninen, Enrique Lopez; Denecke, Timm; Stelter, Lars; Pech, Maciej; Podrabský, P; Pratschke, Johann; Ricke, Jens; Schindler, Ralf; Neuhaus, P.; Felix, R; Tullius, Stefen G.

doi:10.1111/j.1432-2277.2005.00196.x

Cited by 55 publications

(37 citation statements)

References 25 publications

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“…ERA and ED are of particular importance for the decision on the site of nephrectomy. 12 The presence of renal artery variations in the donor kidney substantially increases the risk of complications, given the technical difficulties and longer anastomosis time. 6,13,14 The successful implantation of a renal stent also requires precise knowledge of the origin of the renal arteries from the aorta.…”

Section: Discussionmentioning

confidence: 99%

Variations of Renal Artery in 820 Patients Using 64-Detector CT-Angiography

et al. 2012

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Purpose: Renal artery variations are important for clinical reasons. The aim of this study is to determine the originating level and variations of renal arteries with 64-channel multidetector computed tomography (MDCT). Materials and methods: In a university hospital, 820 patients who underwent MDCT angiography of the abdominal aorta were retrospectively evaluated. The number, early division (ED), and originating level of renal artery were evaluated retrospectively. Variations of the renal artery on both sides, the difference between the genders with variations of the renal artery, were compared with chi-square test. Results: Renal artery originating from the level of L1-L2 intervertebral disc was found in 37.0% and 38.9% of patients on the right and left sides, respectively. Renal artery variations, including extrarenal artery (ERA), were found in 27% and ED in 26.7% of the patients. Significant differences were found in ED and ERA prevalence for genders (p = 0.006 and p = 0.043, respectively). The prevalence of both variations is higher in males. Conclusions: An awareness of renal vascular variations is very important for both surgeons and radiologists. In this series, renal arterial variations were found in approximately one-fourth of the study population.

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Section: Discussionmentioning

confidence: 99%

Variations of Renal Artery in 820 Patients Using 64-Detector CT-Angiography

et al. 2012

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“…3,4,7 The use of computed tomographic angiography (CTA) to assess the quality of donor kidneys and the renal vasculature is part of the donor workup. 3,5,8 There are inherent risks associated with the medical and radiological evaluation itself, including incidental pathological findings and the emotional impact of being turned down for donation. 7 One review of 1600 potential donors demonstrated that 49% were excluded for medical and ethical reasons.…”

Section: Introductionmentioning

confidence: 99%

Evaluating potential live-renal donors: Causes for rejection, deferral and planned procedure type, a single-centre experience

Perlis

Connelly

Honey

et al. 2013

CUAJ

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Background: Renal transplantation is the preferred therapy to extend life expectancy and quality of life for patients with chronic kidney disease. There are many barriers in the process of live kidney donation that prevent the timely progression from organ requirement to transplantation, including the progression of the live donor through a medical evaluation. We assess how easily patients complete the donor workup, how often the medical evaluation identifies significant incidental findings, and which surgical procedure is planned for organ retrieval. Methods: We reviewed our donor database and the minutes from our multidisciplinary rounds from 2002 to 2008 to assess how medical, radiological and psychological findings were used to decide on the candidacy of potential donors. Results: Half (50.2%) of patients did not pass the initial health screen. Of the 467 patients who progressed beyond the health screen to the computed tomographic angiogram evaluation, 48 (10.3%) were excluded as donors and 419 (89.7%) were accepted. Of those accepted, 136 (32.5%) were conditional on further medical workup. Of the patients accepted (n=419), 375 (89.5%) were planned for laparoscopic left-sided approach. Conclusions: The vast majority of patients who passed the initial health screen for kidney donation will be accepted as donors, but about one-third will require further workup. It is rare to identify life-threatening disease on screening computerized tomographic angiograph for kidney donor workup.

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“…A comprehensive anatomic evaluation of potential renal donors is crucial when harvesting is performed using the laparoscopic technique. Multiphase MDCT is an accurate and useful technique for providing a comprehensive preoperative evaluation of renal donors [19,22,23].…”

Section: Discussionmentioning

confidence: 99%

“…MPR and CPR images are particularly useful for correct evaluation of the arterial luminal diameter [21]. VR images can be used for the overall display of the abdominal vasculature and can provide an insight for the interpreter and referring physicians [22,10]. Finally, the axial source images should always be reviewed for possible presence of an accompanying non-vascular pathology.…”

Section: Image Acquisitionmentioning

confidence: 99%

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Multidetector Computed Tomography of Renal Vasculature. Anatomy and Normal Variants.

Hassan

ELKammash

Alam

2014

Zagazig University Medical Journal

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Multi Detector Computed Tomography Angiography (MDCTA) provides a fast, non-invasive modality for the evaluation of the renal vascular pedicle. CTA can reliably and accurately depict the renal arteries and veins and approaches conventional angiography in the assessment of most vascular abnormalities. Knowledge of the variations in renal vascular anatomy is important before laparoscopic donor or partial nephrectomy and vascular reconstruction for renal artery stenosis or abdominal aortic aneurysm. Objective: To illustrate the diagnostic accuracy of MDCT for evaluation of renal vasculature anatomy. Design: An analytic, comparative study. Subjects: fifty six patients including 43 living renal donors, 13 hypertension and abdominal pain (27 men and 29 women, mean age 39.5 years) were examined from January 2008 to September 2010 in Radiology department, Farwania hospital Kuwait. Gold standard was the operative data, conventional angiography or DSA. Main outcome: The value of MDCT in assessment of renal vascular anomalies. Results: Renal vascular anatomical variants included multiple arteries (21.4%), multiple veins (7.1%), early arterial bifurcation (8.9%), late venous confluence (7.1%), circum-aortic renal veins (7.1%) and retro-aortic vein (3.6%). The sensitivity and specificity of multiple arterial anomalies were 91.7% and 97.7%, respectively. The sensitivity and specificity of multiple venous anomalies were 85.7% and 97.6%, respectively. Conclusion: MDCT is valuable for detection of renal vascular anomalies.

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Preoperative evaluation of living kidney donors using multirow detector computed tomography: comparison with digital subtraction angiography and intraoperative findings

Cited by 55 publications

References 25 publications

Variations of Renal Artery in 820 Patients Using 64-Detector CT-Angiography

Variations of Renal Artery in 820 Patients Using 64-Detector CT-Angiography

Evaluating potential live-renal donors: Causes for rejection, deferral and planned procedure type, a single-centre experience

Multidetector Computed Tomography of Renal Vasculature. Anatomy and Normal Variants.

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