title: Evaluation of potential renal transplant recipients with computed tomography angiography.
abstract: OBJECTIVE
  To determine the safety, clinical yield, and cost of computed tomography angiography (CTA) use in the workup of potential renal transplant recipients.
  
  
  METHODS
  Single-site, retrospective review of medical, surgical, and radiologic records.
  
  
  METHODS
  Large university tertiary care center.
  
  
  METHODS
  Potential recipients of transplants from living donors.
  
  
  METHODS
  Computed tomography with and without 100 mL of iodixanol intravenous contrast enhancement as part of the preoperative workup.
  
  
  METHODS
  Mean pre- and post-CTA estimated glomerular filtration rate and number of patients requiring emergent dialysis after CTA, number of patients who had their treatment changed by CTA findings, patient predictors of significant CTAs, and cost per significant CTA.
  
  
  RESULTS
  From July 20, 2006, through December 10, 2010, a total of 179 transplant candidates underwent CTA. Forty-two patients were predialysis at the time of CTA. Mean (SD) serum creatinine levels in this group were unchanged after CTA (5.06 [2.13] mg/dL vs 5.00 [2.28] mg/dL [to convert to micromoles per liter, multiply by 88.4], P = .49), and no patients required subsequent emergent dialysis. Forty-one patients (22.9%) had their treatment changed by CTA findings. Multivariate logistic regression analysis revealed 3 patient history and physical criteria that predicted significant CTA findings: chronic infection (odds ratio, 10.91; 95% CI, 2.72-43.69; P < .001), patient weight less than 69 kg (3.11; 1.49-6.51; P < .001), and ventral torso surgical scarring (4.13; 1.57-10.84; P < .001). Diagnostic cost per significant CTA study was $2660, with an estimated reduced cost of $1480 per significant study with screening using 1 of the 3 predictors.
  
  
  CONCLUSIONS
  Diagnostic CTA is a safe and cost-effective procedure for both operative planning and screening for potentially prohibitive abdominal disease.
authors.forename: Daniel
authors.initials: D
authors.lastname: Smith
authors.forename: Avni
authors.initials: A
authors.lastname: Chudgar
authors.forename: Barry
authors.initials: B
authors.lastname: Daly
authors.forename: Matthew
authors.initials: M
authors.lastname: Cooper
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography / Q000009:adverse effects / Q000191:economics*; D003287:Contrast Media; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D019990:Perioperative Care / Q000009:adverse effects / Q000191:economics*; D011237:Predictive Value of Tests; D051437:Renal Insufficiency / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000191:economics*; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol