title: Volume matters: CT-based renal cortex volume measurement in the evaluation of living kidney donors.
abstract: Currently, no international standard for the pre-transplant evaluation of living donor renal function exists. Following a standardized questionnaire on current practice in all Eurotransplant (ET) centers, we compared a new CT-based technique to measure renal cortex volume with our standard of DTPA-clearance combined with MAG3-scintigraphy (DTPA × MAG3) and with creatinine-based methods in 167 consecutive living kidney donors. Most ET centers use creatinine-clearance (64%) to measure total renal function and radioistopic methods (82%) to assess split renal function. Before transplantation, CT-measured total cortex volume (r = 0.67; P < 0.001) and estimated GFR using the Cockcroft-Gault formula [eGFR(CG)] (r = 0.55; P < 0.001) showed the strongest correlation with DTPA-clearance. In contrast, the correlation between DTPA-clearance and creatinine clearance was weak (r = 0.21; P = 0.02). A strong correlation was observed between CT-measured split cortex volume and MAG3-measured split renal function (r = 0.93; P < 0.001). A strong correlation was also found between pre-transplant split renal function assessed by eGFR(CG) together with cortex volume measurement and post-transplant eGFR(CG) of both, the donor (r = 0.83; P < 0.001) and the recipient (r = 0.75; P < 0.001). In conclusion CT-based assessment of renal cortex volume bears the potential to substitute existing methods to assess pre-transplant living donor split renal function.
authors.affiliation: Department of Nephrology, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Halleck
authors.forename: Gerd
authors.initials: G
authors.lastname: Diederichs
authors.forename: Torsten
authors.initials: T
authors.lastname: Koehlitz
authors.forename: Torsten
authors.initials: T
authors.lastname: Slowinski
authors.forename: Florian
authors.initials: F
authors.lastname: Engelken
authors.forename: Lutz
authors.initials: L
authors.lastname: Liefeldt
authors.forename: Frank
authors.initials: F
authors.lastname: Friedersdorff
authors.forename: T Florian
authors.initials: TF
authors.lastname: Fuller
authors.forename: Ahmed
authors.initials: A
authors.lastname: Magheli
authors.forename: Hans-H
authors.initials: HH
authors.lastname: Neumayer
authors.forename: Klemens
authors.initials: K
authors.lastname: Budde
authors.forename: Johannes
authors.initials: J
authors.lastname: Waiser
mesh_terms: D003404:Creatinine; D005919:Glomerular Filtration Rate; D006801:Humans; D007672:Kidney Cortex / Q000000981:diagnostic imaging*; D007677:Kidney Function Tests / Q000379:methods*; D019520:Living Donors; D004369:Pentetic Acid; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D004369:Pentetic Acid; D003404:Creatinine
keywords: CT-based renal cortex volume; kidney transplantation; living kidney donation; scintigraphy