Skip to main content
SpringerLink
Log in

Pre-operative assessment of living renal transplant donors with state-of-the-art imaging modalities: computed tomography angiography versus magnetic resonance angiography in 118 patients

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To compare current technology multislice computed tomography angiography (CTA) with magnetic resonance angiography (MRA) in the pre-operative evaluation of vascular anatomy of living renal transplant donors.

Methods and materials

Two hundred and thirty-six kidneys were included in the CTA and MRA analysis. Renal vasculature was evaluated independently by two readers in each modality with a delay of 4 weeks between reading sessions. Surgical correlation on the operated side was available in all patients. The reference standard was defined by surgical correlation and consensus reading of both modalities.

Results

Detection rate of CTA for arteries was 99.1 and 95.0 % for reader 1 and reader 2, respectively. Detection rate of MRA for arteries was 95.0/94.3 %. Most of the undetected arteries were ≤1 mm diameter (reader 1: 2 of 3 in CTA and 9 of 16 in MRA; reader 2: 11 of 16 in CTA, and 8 of 18 in MRA). Detection rates for arteries ≥2 mm for reader 1/reader 2 were 99.7/98.7 % in CTA and 99.1/97.8 % in MRA, respectively. Detection rates for veins were 99.6/97.4 % in CTA and 97.8/96.9 % in MRA, respectively. Both readers misdiagnosed between 0 and 1 non-present arteries and between 2 and 3 non-present veins in both modalities.

Conclusions

Modern multislice CT and MRI scanners allow highly accurate evaluation of the vascular anatomy, especially for vessels of ≥2 mm diameter. CTA may provide slightly better depiction of very small arteries; however, this may be reader-dependent. Additional factors affecting the choice of imaging modality should include local availability, cost, and the desire to avoid ionizing radiation in healthy transplant donors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Carter JT, Freise CE, McTaggart RA, Mahanty HD, Kang SM, Chan SH et al (2005) Laparoscopic procurement of kidneys with multiple renal arteries is associated with increased ureteral complications in the recipient. Am J Transplant 5:1312–1318

    Article  PubMed  Google Scholar 

  2. Fuller TF, Deger S, Buchler A, Roigas J, Schonberger B, Schnorr D et al (2006) Ureteral complications in the renal transplant recipient after laparoscopic living donor nephrectomy. Eur Urol 50:535–540 discussion 40-1

    Article  PubMed  Google Scholar 

  3. Aktas S, Boyvat F, Sevmis S, Moray G, Karakayali H, Haberal M (2011) Analysis of vascular complications after renal transplantation. Transplant Proc 43:557–561

    Article  PubMed  CAS  Google Scholar 

  4. Chabchoub K, Mhiri MN, Bahloul A, Fakhfakh S, Ben Hmida I, Hadj Slimen M et al (2011) Does kidney transplantation with multiple arteries affect graft survival? Transplant Proc 43:3423–3425

    Article  PubMed  CAS  Google Scholar 

  5. Paragi PR, Klaassen Z, Fletcher HS, Tichauer M, Chamberlain RS, Wellen JR et al (2011) Vascular constraints in laparoscopic renal allograft: comparative analysis of multiple and single renal arteries in 976 laparoscopic donor nephrectomies. World J Surg 35:2159–2166

    Article  PubMed  Google Scholar 

  6. Yildirim M, Kucuk HF (2011) Outcomes of renal transplantations with multiple vessels. Transplant Proc 43:816–818

    Article  PubMed  CAS  Google Scholar 

  7. Kok NF, Dols LF, Hunink MG, Alwayn IP, Tran KT, Weimar W et al (2008) Complex vascular anatomy in live kidney donation: imaging and consequences for clinical outcome. Transplantation 85:1760–1765

    Article  PubMed  Google Scholar 

  8. Bhatti AA, Chugtai A, Haslam P, Talbot D, Rix DA, Soomro NA (2005) Prospective study comparing three-dimensional computed tomography and magnetic resonance imaging for evaluating the renal vascular anatomy in potential living renal donors. BJU Int 96:1105–1108

    Article  PubMed  Google Scholar 

  9. Gluecker TM, Mayr M, Schwarz J, Bilecen D, Voegele T, Steiger J et al (2008) Comparison of CT angiography with MR angiography in the preoperative assessment of living kidney donors. Transplantation 86:1249–1256

    Article  PubMed  Google Scholar 

  10. Halpern EJ, Mitchell DG, Wechsler RJ, Outwater EK, Moritz MJ, Wilson GA (2000) Preoperative evaluation of living renal donors: comparison of CT angiography and MR angiography. Radiology 216:434–439

    PubMed  CAS  Google Scholar 

  11. Kim T, Murakami T, Takahashi S, Hori M, Takahara S, Ichimaru N et al (2006) Evaluation of renal arteries in living renal donors: comparison between MDCT angiography and gadolinium-enhanced 3D MR angiography. Radiat Med 24:617–624

    Article  PubMed  Google Scholar 

  12. Rankin SC, Jan W, Koffman CG (2001) Noninvasive imaging of living related kidney donors: evaluation with CT angiography and gadolinium-enhanced MR angiography. AJR Am J Roentgenol 177:349–355

    Article  PubMed  CAS  Google Scholar 

  13. Tsuda K, Murakami T, Kim T, Narumi Y, Takahashi S, Tomoda K et al (1998) Helical CT angiography of living renal donors: comparison with 3D Fourier transformation phase contrast MRA. J Comput Assist Tomogr 22:186–193

    Article  PubMed  CAS  Google Scholar 

  14. Turk IA, Deger S, Davis JW, Giesing M, Fabrizio MD, Schonberger B et al (2002) Laparoscopic live donor right nephrectomy: a new technique with preservation of vascular length. J Urol 167:630–633

    Article  PubMed  Google Scholar 

  15. Giessing M, Deger S, Schonberger B, Turk I, Loening SA (2003) Laparoscopic living donor nephrectomy: from alternative to standard procedure. Transplant Proc 35:2093–2095

    Article  PubMed  CAS  Google Scholar 

  16. Satyapal KS, Rambiritch V, Pillai G (1995) Additional renal veins: incidence and morphometry. Clin Anat 8:51–55

    Article  PubMed  CAS  Google Scholar 

  17. Pollak R, Prusak BF, Mozes MF (1986) Anatomic abnormalities of cadaver kidneys procured for purposes of transplantation. Am Surg 52:233–235

    PubMed  CAS  Google Scholar 

  18. Laugharne M, Haslam E, Archer L, Jones L, Mitchell D, Loveday E et al (2007) Multidetector CT angiography in live donor renal transplantation: experience from 156 consecutive cases at a single centre. Transpl Int 20:156–166

    Article  PubMed  Google Scholar 

  19. Tombul ST, Aki FT, Gunay M, Inci K, Hazirolan T, Karcaaltincaba M et al (2008) Preoperative evaluation of hilar vessel anatomy with 3-D computerized tomography in living kidney donors. Transplant Proc 40:47–49

    Article  PubMed  CAS  Google Scholar 

  20. Hodgson DJ, Jan W, Rankin S, Koffman G, Khan MS (2006) Magnetic resonance renal angiography and venography: an analysis of 111 consecutive scans before donor nephrectomy. BJU Int 97:584–586

    Article  PubMed  Google Scholar 

  21. Monroy-Cuadros M, McLaughlin K, Salazar A, Yilmaz S (2008) Assessment of live kidney donors by magnetic resonance angiography: reliability and impact on outcomes. Clin Transplant 22:29–34

    PubMed  Google Scholar 

  22. Neville C, House AA, Nguan CY, Beasley KA, Peck D, Thain LM et al (2008) Prospective comparison of magnetic resonance angiography with selective renal angiography for living kidney donor assessment. Urology 71:385–389

    Article  PubMed  Google Scholar 

  23. Israel GM, Lee VS, Edye M, Krinsky GA, Lavelle MT, Diflo T et al (2002) Comprehensive MR imaging in the preoperative evaluation of living donor candidates for laparoscopic nephrectomy: initial experience. Radiology 225:427–432

    Article  PubMed  Google Scholar 

  24. Asgari MA, Dadkhah F, Ghadian AR, Razzaghi MR, Noorbala MH, Amini E (2011) Evaluation of the vascular anatomy in potential living kidney donors with gadolinium-enhanced magnetic resonance angiography: comparison with digital subtraction angiography and intraoperative findings. Clin Transplant 25:481–485

    Article  PubMed  Google Scholar 

  25. Platt JF, Ellis JH, Korobkin M, Reige K (1997) Helical CT evaluation of potential kidney donors: findings in 154 subjects. AJR Am J Roentgenol 169:1325–1330

    Article  PubMed  CAS  Google Scholar 

  26. Kim JK, Park SY, Kim HJ, Kim CS, Ahn HJ, Ahn TY et al (2003) Living donor kidneys: usefulness of multi-detector row CT for comprehensive evaluation. Radiology 229:869–876

    Article  PubMed  Google Scholar 

  27. Namasivayam S, Kalra MK, Waldrop SM, Mittal PK, Small WC (2006) Multidetector row CT angiography of living related renal donors: is there a need for venous phase imaging? Eur J Radiol 59:442–452

    Article  PubMed  Google Scholar 

  28. Namasivayam S, Small WC, Kalra MK, Torres WE, Newell KA, Mittal PK (2006) Multidetector-row CT angiography for preoperative evaluation of potential laparoscopic renal donors: how accurate are we? Clin Imaging 30:120–126

    Article  PubMed  Google Scholar 

  29. Sahani DV, Rastogi N, Greenfield AC, Kalva SP, Ko D, Saini S et al (2005) Multi-detector row CT in evaluation of 94 living renal donors by readers with varied experience. Radiology 235:905–910

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, Charité–Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany

    F. Engelken, B. Hamm & G. Diederichs

  2. Department of Urology, Charité–Universitätsmedizin Berlin, Charitéplatz 1, Campus Mitte, 10117, Berlin, Germany

    F. Friedersdorff, T. F. Fuller & A. Magheli

  3. Department of Nephrology, Charité–Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany

    K. Budde, F. Halleck & L. Liefeldt

  4. Department of Urology, Heinrich-Heine Universität Düsseldorf, Düsseldorf, Germany

    M. Giessing

  5. Department of Urology, Paracelsus-Krankenhaus Ruit, Ostfildern, Germany

    S. Deger

Authors
  1. F. Engelken
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. Friedersdorff
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T. F. Fuller
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Magheli
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Budde
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F. Halleck
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. Deger
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. L. Liefeldt
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. B. Hamm
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. M. Giessing
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. G. Diederichs
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F. Friedersdorff.

Additional information

F. Engelken and F. Friedersdorff equally contributing first authors.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Engelken, F., Friedersdorff, F., Fuller, T.F. et al. Pre-operative assessment of living renal transplant donors with state-of-the-art imaging modalities: computed tomography angiography versus magnetic resonance angiography in 118 patients. World J Urol 31, 983–990 (2013). https://doi.org/10.1007/s00345-012-1022-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-012-1022-y

Keywords

Search

Navigation