MP29-20 COMPARISON OF CT-MEASURED SPLIT RENAL VOLUME AND SPLIT RENAL FUNCTION BY DTPA CINTIGRAPHY FOR THE PREDICTION OF 12 MONTHS KIDNEY GRAFT FUNCTION

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery I1 Apr 2016MP29-20 COMPARISON OF CT-MEASURED SPLIT RENAL VOLUME AND SPLIT RENAL FUNCTION BY DTPA CINTIGRAPHY FOR THE PREDICTION OF 12 MONTHS KIDNEY GRAFT FUNCTION Diogo Gil-Sousa, Jorge Dias, Daniel Oliveira-Reis, Diogo Carneiro, Jorge Malheiro, Manuela Almeida, Leonídio Dias, António Castro-Henriques, José Soares, Avelino Fraga, and Miguel Silva Ramos Diogo Gil-SousaDiogo Gil-Sousa More articles by this author , Jorge DiasJorge Dias More articles by this author , Daniel Oliveira-ReisDaniel Oliveira-Reis More articles by this author , Diogo CarneiroDiogo Carneiro More articles by this author , Jorge MalheiroJorge Malheiro More articles by this author , Manuela AlmeidaManuela Almeida More articles by this author , Leonídio DiasLeonídio Dias More articles by this author , António Castro-HenriquesAntónio Castro-Henriques More articles by this author , José SoaresJosé Soares More articles by this author , Avelino FragaAvelino Fraga More articles by this author , and Miguel Silva RamosMiguel Silva Ramos More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1104AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Living donor kidney transplantation (KT) has broadened the availability of kidney grafts, allowing a partial response to the growing number of patients with end-stage renal disease for whom KT is indicated. Although living donor KT evaluation is paramount to maximize kidney graft function, no clear international guidelines exist. We aimed to evaluate and correlate the living donor DTPA-measured and CT-measured split renal function in the prediction of kidney graft function at 12 months. METHODS Retrospective analysis of 110 living donor KT pairs performed by a single academic institution between May 2008 and September 2014. All living donors underwent preoperative DTPA Cintigraphy and renal imaging with 3D helicoidal CT. Renal volumes were obtained for each donor using the voxel counting technique. Pre-KT donor eGFR was calculated using MDRD equation, and recipient graft function at 12-months was estimated by MDRD formula. Split renal function was determined by DTPA-measured split function (%DTPA) and by CT-measured split volume (%TC). Correlation between both living donor split renal function approaches and graft function at 12 months was performed using Pearson Correlation and Receiver Operating Characteristic (ROC) curves. RESULTS Mean donor and recipient age were 47,1±10,4 and 39.2±13,2 years, respectively. Donor mean total kidney volume was 318,8±42,4cc/1,73m2, with a mean CT-measured transplanted kidney split volume of 51,0±4,0%. Mean DTPA-measured transplanted kidney split function was 49,3±3,6%. Pearson Correlation Coefficient (r) between the pre-transplant split renal function of the transplanted kidney (calculated by %CT or %DTPA and MDRD eGFR) and graft function at 12 months, showed a strong correlation for both split renal function measurement techniques, with a trend to better predictive value for CT: r (eGFR-DTPA% transplanted Kidney) 0,350 Vs. r (eGFR-CT% transplanted Kidney) 0,363. In addition, a cut-off of <50 mL/min/1.73 m2 was used to define impaired kidney graft function at 12 months. Performing a ROC analyses between the pre-transplantation split renal function (according to %DTPA or %CT and MDRD eGFR) and impaired kidney graft function, we observe that all split function estimates were highly predictive of recipient graft function outcome (p<0,001), though %TC estimates presented the highest AUCs (AUC eGFR(MDRD)*%DTPA=0,778 Vs. AUC eGFR(MDRD)*%TC=0,822). CONCLUSIONS Preoperative CT-measured split renal volume proved to be as correlated with recipient eGFR at 12 months as split renal function by DTPA. CT-based split function has shown to be a slightly better predictor of impaired kidney graft function than DTPA-based split function. CT split renal volume evaluation seems to bear the potential to substitute current methods, as renal cintigraphy, in the evaluation of pre-transplant split renal function, allowing for a better allocation of means in living-donor KT. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e388 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Diogo Gil-Sousa More articles by this author Jorge Dias More articles by this author Daniel Oliveira-Reis More articles by this author Diogo Carneiro More articles by this author Jorge Malheiro More articles by this author Manuela Almeida More articles by this author Leonídio Dias More articles by this author António Castro-Henriques More articles by this author José Soares More articles by this author Avelino Fraga More articles by this author Miguel Silva Ramos More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...