Abstract
Radiological evaluation before renal transplantation includes imaging of vascular anatomy, as thrombosis, narrowing and anomalies of the inferior vena cava (IVC) and/or iliac veins (IV) can influence the surgical technique. Most cases only require investigation with Doppler vessel ultrasonography (US), with magnetic resonance venography (MRV) reserved to clarify US findings and investigate high-risk patients. The purpose of this study was to compare these modalities in evaluating IVC and IV and correlate imaging and operative findings of patients at RTx surgery. Twenty-nine children, 21 (72%) of whom had subsequent RTx surgery, were investigated over 5 years with correlation of US and MRV in 62% (18 of 29). Technically difficult US examinations needing MRV for clarification occurred in six (21%), and normal US with anatomical variations on MRV was seen in three (10%). The anatomical variations consisted of left-sided IVC, aberrant right common femoral vein and a left IV partly draining into the azygos and renal veins. US is an excellent screening tool for evaluating vascular anatomy patency in children. MRV infrequently contributes beneficial information, is difficult to justify as a screening tool, and due to the risks of gadolinium in uraemia, should only be used on an individual patient basis.
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References
Massicotte MP, Dix D, Monagle P, Adams M, Andrew M (1998) Central venous catheter related thrombosis in children: analysis of the Canadian Registry of Venous Thromboembolic Complications. J Pediatr 133(6):770–776
Andrew M, David M, Adams M, Ali K, Anderson R, Barnard D, Bernstein M, Brisson L, Cairney B, DeSai D, Grant R, Israels S, Jardine L, Luke B, Massicotte P, Silva M (1994) Venous thromboembolic complications (VTE) in children: first analyses of the Canadian Registry of VTE. Blood 83(5):1251–1257
Eneriz-Wiemer M, Sarwal M, Donovan D, Costaglio C, Concepcion W, Salvatierra O (2006) Successful renal transplantation in high-risk small children with a completely thrombosed inferior vena cava. Transplantation 82(9):1148–1152
Yata N, Nakanishi K, Uemura S, Ishikura K, Hataya H, Ikeda M, Honda M, Yoshikawa N (2004) Evaluation of the inferior vena cava in potential pediatric renal transplant recipients. Pediatr Nephrol 19(9):1062–1064
Badet L, Lezrek M, Alves Saraiva W, Cherasse A, Pasticier G, Fassi Fehri H, Ranchin B, Cochat P, Colombel M, Martin X (2005) Renal transplantation techniques in children with impaired patency of the inferior vena cava or iliac vein. Prog Urol 15(2):285–290
Hajivassiliou CA, Wilkinson AG, Azmy A (1997) Renal transplantation in a child with iliac vein thrombosis and absence of superior and inferior venae cavae. Nephrol Dial Transplant 12(6):1269–1270
Thomas SE, Hickman RO, Tapper D, Shaw DW, Fouser LS, McDonald RA (2000) Asymptomatic inferior vena cava abnormalities in three children with end-stage renal disease: risk factors and screening guidelines for pretransplant diagnosis. Pediatr Transplant 4(1):28–34
Cheng YF, Huang TL, Lui CC, Lee TY, Chen CL (1997) Magnetic resonance venography in potential pediatric liver transplant recipients. Clin Transplant 11(2):121–126
Finn JP, Zisk JH, Edelman RR, Wallner BK, Hartnell GG, Stokes KR, Longmaid HE (1993) Central venous occlusion: MR angiography. Radiology 187(1):245–251
Rose SC, Gomes AS, Yoon HC (1996) MR angiography for mapping potential central venous access sites in patients with advanced venous occlusive disease. AJR Am J Roentgenol 166(5):1181–1187
Shankar KR, Abernethy LJ, Das KS, Roche CJ, Pizer BL, Lloyd DA, Losty PD (2002) Magnetic resonance venography in assessing venous patency after multiple venous catheters. J Pediatr Surg 37(2):175–179
Mendichovszky IA, Marks SD, Simcock CM, Olsen OE (2007) Gadolinium and nephrogenic systemic fibrosis: time to tighten practice. Pediatr Radiol DOI https://doi.org/10.1007/s00247-007-0633-8
Vester U, Offner G, Hoyer PF, Oldhafer K, Fangmann J, Pichlmayr R, Brodehl J (1998) End-stage renal failure in children younger than 6 years: renal transplantation is the therapy of choice. Eur J Pediatr 157(3):239–242
Marks SD, Massicotte MP, Steele BT, Matsell DG, Filler G, Shah PS, Perlman M, Rosenblum ND, Shah VS (2005) Neonatal renal venous thrombosis: clinical outcomes and prevalence of prothrombotic disorders. J Pediatr 146(6):811–816
Kaste SC, Gronemeyer SA, Hoffer FA, Mandrell BN, Wilimas JA (1999) Pilot study of noninvasive detection of venous occlusions from central venous access devices in children treated for acute lymphoblastic leukemia. Pediatr Radiol 9(8):570–574
Sadowski EA, Bennett LK, Chan MR, Wentland AL, Garrett AL, Garrett RW, Djamali A (2007) Nephrogenic systemic fibrosis: risk factors and incidence estimation. Radiology 243(1):148–157
Revel-Vilk S (2006) Central venous line-related thrombosis in children. Acta Haematol 115(3–4):201–206
Hamilton HC, Foxcroft DR (2007) Central venous access sites for the prevention of venous thrombosis, stenosis and infection in patients requiring long-term intravenous therapy. Cochrane Database Syst Rev 3:CD004084
Grobner T, Prischl FC (2007) Gadolinium and nephrogenic systemic fibrosis. Kidney Int 72(3):260–264
Pfluger T, Czekalla R, Hundt C, Schubert M, Graubner U, Leinsinger G, Scheck R, Hahn K (1999) MR angiography versus color Doppler sonography in the evaluation of renal vessels and the inferior vena cava in abdominal masses of pediatric patients. AJR Am J Roentgenol 173(1):103–108
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Meister, M.G., Olsen, Ø.E., de Bruyn, R. et al. What is the value of magnetic resonance venography in children before renal transplantation?. Pediatr Nephrol 23, 1157–1162 (2008). https://doi.org/10.1007/s00467-008-0784-3
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DOI: https://doi.org/10.1007/s00467-008-0784-3