Use of Multidetector CT in Presurgical Evaluation of Potential Kidney Transplant Recipients

Abstract

Kidney transplantation is the treatment of choice for end-stage renal disease. Optimal presurgical evaluation of the potential kidney transplant recipient is important for the success of the transplantation. Multidetector computed tomography (CT) allows assessment of the feasibility of kidney transplantation; detection of coexisting illnesses that may affect survival of the graft and that must be treated before transplantation; and evaluation of possible peripheral vascular disease, which is present in a significant number of potential kidney transplant recipients. Multidetector CT provides a wide range of information in these patients. Vascular and extravascular systems can be evaluated, allowing one to determine whether kidney transplantation is possible, whether presurgical procedures are necessary, and which is the best surgical technique for each candidate. Knowledge of the surgical techniques, use of an optimal multidetector CT technique, and the ability to identify common and uncommon radiologic findings are essential for correct evaluation of potential kidney transplant recipients.

Renal Transplantation in Patients with Aortoiliac Prosthetic Grafts: A Case Report and Pertinent Review of Literature

“…Despite this study, extensive calcifications were noted interestingly precluding direct arterial anastomosis, further highlighting the necessity for high risk renal transplant recipients to undergo vascular imaging every 6 -12 months while on the transplant list [11]. Therapeutic options are limited in patients with severe calcification of iliac artery and include orthotropic renal transplant or aorta and/or femoral bypass procedures, with or without direct anastomosis of the transplant artery to the prosthetic graft [1] [2] [5] [9] [10]. In the majority of the instances in which sever aortoiliac disease is diagnosed intra-operatively during renal transplantation, anastomosis of renal artery to a vascular prosthetic graft posses a highly technical and unique challenge [2] [5].…”

Evaluation of Potential Renal Transplant Recipients With Computed Tomography Angiography

“…Scanning the vasculature in the 3 phases of precontrast, arterial, and delayed sequencing allows for optimal evaluation of vascular calcification, stenosis or aneurysmal disease, and venous patency, respectively. 30 In this study, 24 of 152 patients (15.8%) who underwent transplantation had the site of anastomosis influenced by CTA findings. This statistic is limited to those patients with grafts transplanted to institutionally nonstandard sites.…”

Pre-existing oral contrast from lanthanum carbonate: a confounding factor in CT mesenteric angiography

“…While the appearance of lanthanum in the bowel has been reported widely in nephrology journals [3,4], the authors could only find two papers in the radiology literature that mention it [2,5]. It is important to note that taken properly, i.e.…”