The Role of MDCT Angiography in Preoperative Evaluation of the Living Renal Donors
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- Category: Vol. 88, March 2020
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The Role of MDCT Angiography in Preoperative Evaluation of the Living Renal Donors, AHMED M. ALAA ELDIN and HEBA F. TANTAWY
Abstract
Background: Renal transplantation is the treatment of choice for patients with end stage renal disease. The transplant surgeon needs accurate preoperative data about the anatomy of renal vasculature to reduce the hazards associated with the procedure. MDCTA is used because it is less invasive, simply appropriate and accessible. It allows accurate imaging of the normal and variant anatomy of the renal vasculature. Aim of Study: To investigate the role of multidetector computed tomography angiography (MDCTA) in evaluating the preoperative anatomy of the renal vasculature in potential renal donors. Subjects and Methods: A total of 30 patients underwent MDCTA as a routine work-up for live renal donors. The number of branches of renal arteries and veins, together with the frequency of incidental findings of the renal parenchyma were assessed. Multiplanar reformations, maximum intensity projections, and volume renderings were used. The results gained were surgically correlated. Results: We recognized surgically important vascular variants and renal parenchymal abnormalities. Eight of 30 (27%) subjects were excluded based on the MDCTA findings, due to vascular causes in 4 cases, recipient death in 2 cases, renal stones in one case, and a horse-shoe kidney in one case. The surgical decision of right nephrectomy was made in one case (4.5%) due to complex vascular anatomy on the left side identified on MDCTA. The surgically established sensitivities of MDCTA data for the detection of the renal arteries and veins were 100% and 95.5%, respectively. Conclusion: MDCTA correctly detected essential exclu-sions for renal donation and aided the choice of the preferred kidney to be harvested based on parenchymal and va scular findings.