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133. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

26.04. - 29.04.2016, Berlin

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Computed Tomography Volumetry in Preoperative Living Kidney Donor Assessment for Prediction of Split Renal Function

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  • Roger Wahba - Uniklinik Köln, Klinik für Allgemein-, Viszeral-, und Tumorchirurgie, Schwerpunkt Transplantationschirurgie, Köln, Deutschland
  • Robert Kleinert - Uniklinik Köln, Klinik für Allgemein-, Viszeral-, und Tumorchirurgie, Schwerpunkt Transplantationschirurgie, Köln, Deutschland
  • Mareike Franke - Uniklinik Köln, Klinik für Allgemein-, Viszeral-, und Tumorchirurgie, Schwerpunkt Transplantationschirurgie, Köln, Deutschland
  • Martin Hellmich - Uniklinik Köln, Klinik für Allgemein-, Viszeral-, und Tumorchirurgie, Schwerpunkt Transplantationschirurgie, Köln, Deutschland
  • Tülay Cingöz - Uniklinik Köln, Klinik für Allgemein-, Viszeral-, und Tumorchirurgie, Schwerpunkt Transplantationschirurgie, Köln, Deutschland
  • Martin C. Schmidt - Uniklinik Köln, Klinik und Poliklinik für Nuklearmedizin, Köln, Deutschland
  • Christopher Bangard - Uniklinik Köln, Klinik für Allgemein-, Viszeral-, und Tumorchirurgie, Schwerpunkt Transplantationschirurgie, Köln, Deutschland
  • Dirk Stippel - Uniklinik Köln, Klinik für Allgemein-, Viszeral-, und Tumorchirurgie, Schwerpunkt Transplantationschirurgie, Köln, Deutschland

Deutsche Gesellschaft für Chirurgie. 133. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 26.-29.04.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16dgch101

doi: 10.3205/16dgch101, urn:nbn:de:0183-16dgch1017

Published: April 21, 2016

© 2016 Wahba et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Background: Transplant centers commonly evaluate split renal function (SRF) with MAG3-scintigraphy (MAG3) in living kidney donation. Alternatively, the kidney volume can be measured based on pre-donation CT-scans. The aim of this study was to identify the most accurate CT-volumetry technique for SRF and the prediction of post-donation kidney function (PDKF).

Materials and methods: Three CT-volumetry techniques (modified ellipsoid volume (MELV), smart ROI volume (ROI), renal cortex volume (RCV)) were performed in 101 living kidney donors. Pre-operation CT-volumetric SRF was determined and compared with MAG3-SRF, post-operation donor kidney function and graft function.

Results: The correlation between donors pre-donation total kidney volume and pre-donation kidney function was the highest for RCV (0.58 with CrCl, 0.54 with eGFR-CG).The pre-donation volume of the preserved kidney was (ROI, MELV, RCV) 148.0±29.1 cm³, 151.2±35.4 and 93.9±25.2 (p<0.005 MELV vs. RCV and ROI vs. RCV). Bland-Altman analysis showed agreement between CT-volumetry SRF and MAG3-SRF (bias, 95% limits of agreement: ROI vs. MAG3 0.4%, -7.7% to 8.6%; MELV vs. MAG3 0.4%, -8.9% to 9.7%; RCV vs. MAG3 0.8%, -9.1% to 10.7%). The correlation between pre-donation CT-volumetric SRF of the preserved kidney and PDKF at day 3 was r=0.85-0.88, between MAG3-SRF and PDKF r=0.84. The difference of pre-donation split renal function between preserved and donated kidney was the lowest for ROI and RCV (median 3% and 4%, 95th percentile 9% and 13%).

Conclusion: Overall renal cortex volumetry seems to be the most accurate technique for the evaluation of pre-donation SRF and allows a reliable prediction of donor’s PDKF.

Figure 1 [Fig. 1]