François Gaillard1, Patrik Pavlov2, Anne-Marie Tissier3, Benoit Harache4, Dominique Eladari5, Marc-Olivier Timsit6, Catherine Fournier7, Carine Léon7, Chantal Hignette4, Gérard Friedlander8, Jean-Michel Correas3, Pierre Weinmann4, Arnaud Méjean6, Pascal Houillier9, Christophe Legendre7, Marie Courbebaisse8. 1. AP-HP, Hôpital Necker-Enfants Malades, Renal Transplantation Department, Paris Descartes University, Paris, France. gaillard-francois@hotmail.fr. 2. Linköping University, Linköping, Sweden. 3. AP-HP, Hôpital Necker-Enfants Malades, Radiology Department, Paris Descartes University, Paris, France. 4. AP-HP, Hôpital Européen Georges Pompidou, Nuclear Medicine Department, Paris Descartes University, Paris, France. 5. AP-HP, Hôpital Européen Georges Pompidou, Physiology Department, Paris Descartes University, and INSERM, Unit 970, Paris, France. 6. AP-HP, Hôpital Européen Georges Pompidou, Urology Department, Paris Descartes University, Paris, France. 7. AP-HP, Hôpital Necker-Enfants Malades, Renal Transplantation Department, Paris Descartes University, Paris, France. 8. AP-HP, Hôpital Européen Georges Pompidou, Physiology Department, Paris Descartes University, and INSERM, Unit 1151, Paris, France. 9. AP-HP, Hôpital Européen Georges Pompidou, Physiology Department, Paris Descartes University, INSERM, Unit umrs1138, and CNRS Unit erl8228, Paris, France.
Abstract
OBJECTIVES: Screening of living kidney donors may require scintigraphy to split glomerular filtration rate (GFR). To determine the usefulness of computed tomography (CT) to split GFR, we compared scintigraphy-split GFR to CT-split GFR. We evaluated CT-split GFR as a screening test to detect scintigraphy-split GFR lower than 40 mL/min/1.73 m2/kidney. METHODS: This was a monocentric retrospective study on 346 potential living donors who had GFR measurement, renal scintigraphy, and CT. We predicted GFR for each kidney by splitting GFR using the following formula: Volume-split GFR for a given kidney = measured GFR*[volume of this kidney/(volume of this kidney + volume of the opposite kidney)]. The same formula was used for length-split GFR. We compared length- and volume-split GFR to scintigraphy-split GFR at donation and with a 4-year follow-up. RESULTS: A better correlation was observed between length-split GFR and scintigraphy-split GFR (r = 0.92) than between volume-split GFR and scintigraphy-split GFR (r = 0.89). A length-split GFR threshold of 45 mL/min/1.73 m2/kidney had a sensitivity of 100 % and a specificity of 75 % to detect scintigraphy-split GFR less than 40 mL/min/1.73 m2/kidney. Both techniques with their respective thresholds detected living donors with similar eGFR evolution during follow-up. CONCLUSION: Length-split GFR can be used to detect patients requiring scintigraphy. KEY POINTS: • Excellent correlation between kidney length and scintigraphy predicted GFR • Kidney length screening detects all donors with GFR lower than 40 mL/min/1.73 m 2 • Kidney length screening can replace scintigraphy screening.
OBJECTIVES: Screening of living kidney donors may require scintigraphy to split glomerular filtration rate (GFR). To determine the usefulness of computed tomography (CT) to split GFR, we compared scintigraphy-split GFR to CT-split GFR. We evaluated CT-split GFR as a screening test to detect scintigraphy-split GFR lower than 40 mL/min/1.73 m2/kidney. METHODS: This was a monocentric retrospective study on 346 potential living donors who had GFR measurement, renal scintigraphy, and CT. We predicted GFR for each kidney by splitting GFR using the following formula: Volume-split GFR for a given kidney = measured GFR*[volume of this kidney/(volume of this kidney + volume of the opposite kidney)]. The same formula was used for length-split GFR. We compared length- and volume-split GFR to scintigraphy-split GFR at donation and with a 4-year follow-up. RESULTS: A better correlation was observed between length-split GFR and scintigraphy-split GFR (r = 0.92) than between volume-split GFR and scintigraphy-split GFR (r = 0.89). A length-split GFR threshold of 45 mL/min/1.73 m2/kidney had a sensitivity of 100 % and a specificity of 75 % to detect scintigraphy-split GFR less than 40 mL/min/1.73 m2/kidney. Both techniques with their respective thresholds detected living donors with similar eGFR evolution during follow-up. CONCLUSION: Length-split GFR can be used to detect patients requiring scintigraphy. KEY POINTS: • Excellent correlation between kidney length and scintigraphy predicted GFR • Kidney length screening detects all donors with GFR lower than 40 mL/min/1.73 m 2 • Kidney length screening can replace scintigraphy screening.
Entities:
Keywords:
CT; kidney; living donor; renal transplantation; split renal function/split GFR
Authors: Alejandro Diez; John Powelson; Chandru P Sundaram; Tim E Taber; Muhammad A Mujtaba; Muhammad S Yaqub; Dennis P Mishler; William C Goggins; Asif A Sharfuddin Journal: Clin Transplant Date: 2014-04-29 Impact factor: 2.863
Authors: M J Bia; E L Ramos; G M Danovitch; R S Gaston; W E Harmon; A B Leichtman; P A Lundin; J Neylan; B L Kasiske Journal: Transplantation Date: 1995-08-27 Impact factor: 4.939
Authors: Hassan N Ibrahim; Robert Foley; LiPing Tan; Tyson Rogers; Robert F Bailey; Hongfei Guo; Cynthia R Gross; Arthur J Matas Journal: N Engl J Med Date: 2009-01-29 Impact factor: 91.245
Authors: Adam L Summerlin; Mark E Lockhart; Andrew M Strang; Peter N Kolettis; Naomi S Fineberg; J Kevin Smith Journal: AJR Am J Roentgenol Date: 2008-11 Impact factor: 3.959
Authors: Steven Habbous; Justin Woo; Ngan N Lam; Krista L Lentine; Matthew Cooper; Marian Reich; Amit X Garg Journal: Transplant Direct Date: 2018-09-20