Correlation Between CT Renal Angiography of Live Kidney Donors and Intraoperative Findings: A Cross-sectional Study.

Abstract

Introduction A comprehensive understanding of the renal vascular anatomy variations is paramount to a successful kidney transplant. This reduces vascular injury risks and minimizes ischemia duration, optimizing surgical outcomes. The current study aims to assess the accuracy of renal computed tomography angiography (CTA) findings of live renal donors by comparing them with intraoperative findings. Methods This prospective cross-sectional study was conducted between October 2018 and February 2020. It included all healthy donors with two kidneys of normal size, shape, and position who were deemed suitable for nephrectomy. The CTA examinations were performed with the same protocol, which combined the vascular-excretory phase. A specialized radiologist confirmed anatomical findings. The CTA results were compared with intraoperative findings, which were documented by the transplantation team. Results The study included 220 patients. The preoperative CTA was highly sensitive and accurate, reaching 99.5% and 98.6%, respectively, for single vessels and 100% sensitivity and accuracy for triple vessels, pelvicalyceal system, and ureter duplication. The sensitivity of CTA for double vessels (vein and artery) was 90% and 92.6%, respectively, while accuracy was 98.6% for both. Conclusion CTA can be used to assess renal arteries and veins for potential renal donors with high accuracy. Although the CTA's minor, statistically non-significant discordance with the surgical findings regarding double arteries and veins, no artery or vein was missed on the CTA. Therefore, the sensitivity of CTA can reach 100%.