Donor Nephrectomy and Autotransplantation

Abstract

In earlier days, conventional arteriography was the standard procedure performed in every patient undergoing a donor nephrectomy. With advances in CT scanning techniques, currently we perform a 3D-CT scan with a video reconstruction as the only preoperative radiographic imaging. The 3D-CT scan provides superb visualization of the renal artery, renal vein, and the interrelationship of these extra-renal vessels. Further, it also evaluates the renal parenchyma for any abnormalities. Finally, the collecting system is imaged as well. I believe that the 3D-CT is the best test for renal vein anatomy. Currently, interventional angiography is performed in addition only in those patients who have multiple renal vessels on 3D-CT. In a recent study, in which 50 potential kidney donors underwent both the 3D-CT scan and conventional arteriography, in every patient that the 3D-CT confirmed a single renal artery and single renal vein bilaterally, arteriography confirmed these findings.[1]