Magnetic resonance angiography for preoperative evaluation of potential kidney donors.
BACKGROUND
Careful evaluation of the renovascular anatomy for living kidney donors is essential to optimize donor and recipient outcomes. Arteriography has been the standard for delineating the renovascular anatomy. However, this procedure is invasive. Magnetic resonance angiography (MRA) is an attractive, noninvasive alternative. The aim of this study was to evaluate the accuracy of MRA in potential living kidney donors.


METHODS
A retrospective comparison of the preoperative MRA results with the intraoperative anatomy was performed in 189 living kidney donors.


RESULTS
MRA interpretations correctly identified the vascular anatomy of the donor kidneys in 173 donors (91.5%). In the remaining 16 patients (8.5%), the MRA interpretation was inaccurate. In 10 patients, the MRA reported fewer arteries than the number encountered during the donor operation, whereas in six patients MRA reported more arteries than what found during operation. In seven patients, MRA supplied additional important anatomical information, including kidney size disparity, the presence of nephrolithiasis, the presence of a renal cyst, and renal artery stenosis. All kidneys were successfully transplanted. The misinterpretation of the MRA did not adversely affect the recipient outcome.


CONCLUSIONS
The noninvasive MRA evaluation of donor renovascular anatomy is an acceptable substitute for traditional angiography.
Rajab
Amer
A
Division of Transplantation, Department of General Surgery, Ohio State University College of Medicine, 1654 Upham Drive, Columbus, Ohio, USA. Rajab-1@medctr.osu.edu
Khabiri
Hooman
H
Pelletier
Ronald P
RP
Henry
Mitchell L
ML
Akin
Baris
B
Elkhammas
Elmahdi
E
Bumgardner
Ginny L
GL
Ferguson
Ronald M
RM
D000328:Adult; D000792:Angiography / Q000191:economics; D001808:Blood Vessels / Q000473:pathology; D005260:Female; D017048:Health Care Costs; D017722:Hospital Charges; D006801:Humans; D016030:Kidney Transplantation; D018810:Magnetic Resonance Angiography / Q000191:economics; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011300:Preoperative Care; D012077:Renal Artery / Q000473:pathology; D012079:Renal Circulation; D012082:Renal Veins / Q000473:pathology; D014019:Tissue Donors; D016896:Treatment Outcome