Purpose: In recent years altruistic patients may donate a kidney to an unrelated patient suffering from ESRD. We aimed at evaluating the role of multiphasic CT in these patients.
Materials and methods: We retrospectively evaluated patients from January 2016 to July 2017 that underwent multiphasic CT studies including non-contrast, arterial phase, venous phase and urographic phase. The studies were performed on 64-256 slice MDCT (Philips, Eindhoven, Nederland). All studies were evaluated for anatomy of the kidneys and collecting systems, as well as extra renal findings using axial slices, MIP and VR reconstructions. All surgical reports were evaluated to calculate sensitivity of imaging findings as well as surgical approach.
Results: During the study period 49 patients were scanned, of which 32 underwent surgery. 38 patients (77.5%) had one right renal artery (RRA), 10 patients (20.5%) had two RRA, one patient (2%) had three RRA. 47 patients (95.9%) had one right renal vein (RRV), two patients (4.1%) had two RRV. 43 patients (87.7%) had one left renal artery (LRA), 5 patients (10.2) had two LRA and one patient (2.1%) had three LRA. 48 patients (97.9%) had one left renal vein (LRV), one patient (2.1%) had two LRV. Following the imaging findings the surgical approach changed in 15.6%. In these patients the right kidney was resected instead of the left one. The sensitivity for arterial anatomy was 94%, in three cases 3 polar arteries were missed but were seen in retrospect; the sensitivity for venous anatomy was 98%, in one case (2%) an accessory RV was missed. Extra renal findings, such as nutcracker syndrome and splenic lesions, were seen in 20% of patients, and in half of them follow up was recommended.
Conclusion: Multiphasic CT is reliable in evaluation of the anatomy of potential kidney donors. Special attention should be given to small arteries and accessory veins. Surgical approach may change based on the findings.
