Renal computed tomography with 3-dimensional angiography and simultaneous measurement of plasma contrast clearance reduce the invasiveness and cost of evaluating living renal donor candidates

Transplantation
B W LindgrenR Lewis

Abstract

Renal computed tomography (CT), 3-dimensional CT angiography (3D-CTA), and simultaneous measurement of glomerular filtration rate (GFR) by x-ray fluorescence determination of plasma contrast clearance (PCC) are alternatives to intravenous urography (IVU), renal arteriography (RA), and 24-hr urine creatinine clearance (CrCl) for evaluation of renal structure and function in living renal donor (LRD) candidates. To determine if CT, 3D-CTA, and PCC provide data comparable to IVU, RA, and CrCl, both methods were used to evaluate 23 LRD candidates. Costs were also compared. Conventional RA identified 19 accessory arteries and one case of medial fibroplasia. Each of these anomalous vessels was recognized on 3D-CTA. Venous anatomy was more clearly delineated on 3D-CTA than the venous phase of conventional RA. CT demonstrated 3 benign cysts and a single, small intraparenchymal calcification in 3 renal units. GFRs measured by PCC and CrCl were 91 +/- 4 and 132 +/- 7 ml/min/1.73m2, respectively (r = 0.64, P < 0.05). Total cost for CT/3D-CTA/PCC was 46% less than that of IVU/RA/CrCl and 40% less than RA/CrCl. CT/3D-CTA/PCC provided reliable structural and functional data at substantially less cost, discomfort, and inconvenience to the livi...Continue Reading

References

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Citations

Jan 29, 2013·Insights Into Imaging·Julio Arévalo PérezIsaac Daimiel Naranjo
Mar 19, 1999·Journal of Vascular and Interventional Radiology : JVIR·H A NelsonH C Yoon
Jan 24, 2007·Transplant International : Official Journal of the European Society for Organ Transplantation·Matthew LaugharneMark Thornton
Mar 25, 1998·Journal of Transplant Coordination : Official Publication of the North American Transplant Coordinators Organization (NATCO)·K FigueroaA L Principe

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