title: Ionizing radiation exposure among kidney transplant recipients due to medical imaging during the pretransplant evaluation.
abstract: OBJECTIVE
  Kidney transplant recipients are at increased risk for malignancies. One recognized risk for malignancy is ionizing radiation. The purpose of this study was to determine, among kidney transplant recipients, the medical imaging procedures that contribute to radiation exposure and their cumulative radiation exposure, as a result of their pretransplant evaluation.
  
  
  METHODS
  Medical records of patients who received a first, kidney-alone transplant during 2008 at a single transplant center were examined. This study identified medical imaging procedures that were performed as prerequisites for deceased donor wait-listing or receipt of live donor kidney transplants and to maintain active status on the wait list. Frequencies of medical imaging procedures and cumulative effective doses of radiation were calculated.
  
  
  RESULTS
  Among the 172 kidney transplant recipients, 905 procedures were performed. Seventy patients (40.7%) were exposed to low dose (0-20 mSv), 51 (29.7%) were exposed to moderate dose (>20-50 mSv), 28 (16.3%) were exposed to high dose (>50-100 mSv), and 23 (13.4%) were exposed to very high dose (>100 mSv) cumulative effective radiation. Nuclear stress tests accounted for 82.9% of the total radiation exposure. In multivariate analysis, older age, diabetes, and black race were associated with exposure to >20 mSv radiation during the pretransplant evaluation.
  
  
  CONCLUSIONS
  Kidney transplant recipients are exposed to large amounts of ionizing radiation from medical imaging during the pretransplant evaluation. The effects of radiation upon malignancy risk and strategies to reduce this radiation exposure warrant further investigation.
authors: Renal and Pancreas Transplant Division, Saint Barnabas Medical Center, Livingston, New Jersey 07039, USA.
authors: Kim N
authors: KN
authors: Nguyen
authors: Anup M
authors: AM
authors: Patel
authors: Francis L
authors: FL
authors: Weng
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000367:Age Factors; D016009:Chi-Square Distribution; D003920:Diabetes Mellitus / Q000208:ethnology; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009515:New Jersey; D016017:Odds Ratio; D011300:Preoperative Care; D011829:Radiation Dosage; D012189:Retrospective Studies; D012307:Risk Factors; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed; D014850:Waiting Lists; D055815:Young Adult
references: J Am Soc Echocardiogr. 2011 Mar;24(3):229-67
references: 21338862
references: Ann ICRP. 2007;37(6):1-63
references: 18762065
references: Am J Kidney Dis. 2000 Jul;36(1):145-52
references: 10873884
references: Am J Kidney Dis. 2005 Apr;45(4 Suppl 3):S1-153
references: 15806502
references: J Am Soc Nephrol. 2011 Mar;22(3):571-8
references: 21355057
references: Ann ICRP. 1998;28(3):1-126
references: 10840563
references: Radiat Res. 1996 Jul;146(1):1-27
references: 8677290
references: Abdom Imaging. 2012 Aug;37(4):632-8
references: 21842156
references: J Am Soc Nephrol. 2002 Feb;13(2):528-535
references: 11805184
references: Circulation. 2007 Sep 11;116(11):1290-305
references: 17846343
references: Lancet. 1973 Jul 14;2(7820):55-7
references: 4123616
references: Clin J Am Soc Nephrol. 2011 May;6(5):1185-91
references: 21511835
references: Radiat Res. 2003 Oct;160(4):381-407
references: 12968934
references: Ann ICRP. 2007;37(2-4):1-332
references: 18082557
references: Radiology. 2009 Nov;253(2):520-31
references: 19789227
references: J Am Coll Cardiol. 2008 Mar 18;51(11):1127-47
references: 18342240
references: Clin J Am Soc Nephrol. 2008 Jul;3(4):1115-24
references: 18417743
references: Radiology. 2008 Jul;248(1):254-63
references: 18566177
references: Am J Med Sci. 2003 Apr;325(4):163-7
references: 12695721
references: Nephrol Dial Transplant. 2012 Sep;27(9):3645-51
references: 22619314
references: JAMA. 2009 Feb 4;301(5):545-7
references: 19190321
references: Kidney Int. 2010 Oct;78(8):789-93
references: 20592715
references: J Am Coll Cardiol. 2007 Oct 23;50(17):1707-32
references: 17950159
references: N Engl J Med. 2007 Apr 12;356(15):1503-16
references: 17387127
references: Radiat Prot Dosimetry. 2008;128(1):1-4
references: 17951608
references: N Engl J Med. 2009 Aug 27;361(9):849-57
references: 19710483