Bilan tomodensitométrique thoracique et abdomino-pelvien chez les patients insuffisants rénaux candidats à une transplantation rénale : intérêts et indications

Introduction

Screening for neoplasms and vascular calcifications is a key step before kidney transplantation. American, European and French recommendations diverge on the imaging assessment to be carried out in this context.

Method

We carried out a retrospective single-center study including patients who underwent imaging for kidney transplantation between the 01/01/2011 and the 12/31/2018. The neoplastic pathologies and vascular calcifications discovered on this assessment were noted.

Results

We included 579 patients: 293 performed a thoracic CT scan, 579 an abdominopelvic CT scan. The imaging work-up revealed 5 malignant thoracic tumors, 14 malignant abdominal tumors and 140 significant calcifications of the external iliac axes. All malignant chest tumors were found in patients with estimated smoking greater than or equal to 30 PY.

Discussion

Like the American recommendations, our results are in favor of performing a chest computed tomography in patients with smoking greater than or equal to 30 PY. Contrary to American and European recommendations, our results are in favor of performing an abdominopelvic tomodensitometry in all patients.

Conclusion

Screening for vascular calcifications and neoplasms in kidney transplant candidates should include routine abdominopelvic CT and chest CT for smoking greater than or equal to 30 PY.