BACKGROUND: Kidney allograft retrieval from live donors requires accurate determination of kidney anatomy prior to surgery, particularly the arterial supply. Traditionally, conventional angiography has been used to obtain this information. Magnetic resonance angiography (MRA) offers a non-invasive, cost-effective alternative, but has been considered to be less accurate. Despite this criticism, many centers have moved to MRA screening of potential kidney donors. The objective of this study is to evaluate our experience of the reliability of MRA in determining the arterial anatomy of living kidney donors as compared to the intra-operative findings. METHODS: We performed a retrospective review of gadolinium-enhanced, ultra-fast, three-dimensional, spoiled gradient-echo MRA in live kidney donors in the Southern Alberta Transplant Program and compared these results with the intra-operative findings during nephrectomy, as the gold standard. RESULTS: Of the 66 patients, an accessory renal artery was found intra-operatively in eight cases; two of which were erroneously diagnosed as normal by MRA. The negative predictive value for MRA was 0.97, false-negative rate was 0.25, and sensitivity was 0.75. No patient experienced side-effects from the MRA procedure. No donor needed conversion to open nephrectomy because of an undetected accessory renal artery. One allograft with an accessory renal artery developed thrombosis of the lower pole of the kidney despite arterial reconstruction. Kidney function in the recipient of this allograft was excellent and there was no urinary leak. CONCLUSION: In our hands, MRA determined the vascular anatomy of potential kidney donors with an acceptable negative predictive value of 97%.
BACKGROUND: Kidney allograft retrieval from live donors requires accurate determination of kidney anatomy prior to surgery, particularly the arterial supply. Traditionally, conventional angiography has been used to obtain this information. Magnetic resonance angiography (MRA) offers a non-invasive, cost-effective alternative, but has been considered to be less accurate. Despite this criticism, many centers have moved to MRA screening of potential kidney donors. The objective of this study is to evaluate our experience of the reliability of MRA in determining the arterial anatomy of living kidney donors as compared to the intra-operative findings. METHODS: We performed a retrospective review of gadolinium-enhanced, ultra-fast, three-dimensional, spoiled gradient-echo MRA in live kidney donors in the Southern Alberta Transplant Program and compared these results with the intra-operative findings during nephrectomy, as the gold standard. RESULTS: Of the 66 patients, an accessory renal artery was found intra-operatively in eight cases; two of which were erroneously diagnosed as normal by MRA. The negative predictive value for MRA was 0.97, false-negative rate was 0.25, and sensitivity was 0.75. No patient experienced side-effects from the MRA procedure. No donor needed conversion to open nephrectomy because of an undetected accessory renal artery. One allograft with an accessory renal artery developed thrombosis of the lower pole of the kidney despite arterial reconstruction. Kidney function in the recipient of this allograft was excellent and there was no urinary leak. CONCLUSION: In our hands, MRA determined the vascular anatomy of potential kidney donors with an acceptable negative predictive value of 97%.
Authors: I Laurence; B Ariff; R A Quest; S Moser; A Glover; D Taube; P Gishen; V Papalois; C Juli Journal: Br J Radiol Date: 2012-01-17 Impact factor: 3.039
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Authors: Fernanda Garozzo Velloni; Patrícia Prando Cardia; Ulysses Dos Santos Torres; Marco Antonio Haddad Pereira; Thiago José Penachim; Larissa Rossini Favaro; Miguel Ramalho; Giuseppe D'Ippolito Journal: Radiol Bras Date: 2020 Jul-Aug
Authors: Ngan N Lam; Christine Dipchand; Marie-Chantal Fortin; Bethany J Foster; Anand Ghanekar; Isabelle Houde; Bryce Kiberd; Scott Klarenbach; Greg A Knoll; David Landsberg; Patrick P Luke; Rahul Mainra; Sunita K Singh; Leroy Storsley; Jagbir Gill Journal: Can J Kidney Health Dis Date: 2020-06-09