Computerized Tomographic Angiography for Renal Donor Evaluation Leads to a Higher Exclusion Rate

Andrew M. Strang, Mark E. Lockhart, Philip J. Kenney, Christopher Amling, Donald A. Urban, Rizk El-Galley, John R. Burns, Jan L. Colli, Lee N. Hammontree, Peter N. Kolettis

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Purpose: We compared the exclusion rate for potential living renal donors evaluated with computerized tomography angiography and radionuclide renal scintigraphy (renal scan) vs excretory urogram, renal scan and renal arteriography. Materials and Methods: From March 2004 through February 2006, 603 consecutive patients were evaluated as potential living renal donors. From March 2004 through February 2005, 270 consecutive patients underwent evaluation with excretory urogram, renal scan and renal angiography (group 1). Of these patients 16 underwent computerized tomography to evaluate abnormalities detected on excretory urogram. From March 2005 through February 2006, 333 consecutive patients underwent evaluation with computerized tomography angiography and renal scan (group 2). The number of patients excluded for medical reasons and/or radiographic abnormalities was determined for the 2 groups. Results: More than twice as many patients evaluated with computerized tomography were excluded. In group 1, 7% of patients (20 of 270) were excluded from donation due to radiographic findings vs 16% (53 of 333) in group 2 (p = 0.0016). Of the patients 26% and 23% were excluded from renal donation for medical reasons in groups 1 and 2, respectively (p = 0.5059). Conclusions: Multidetector row computerized tomography angiography increases the detection of incidental radiographic abnormalities as well as the renal donor exclusion rate. The increased sensitivity of computerized tomography angiography has created a dilemma for those determining patient eligibility for kidney donation because the clinical significance of many of these findings is unclear. Additional studies should address the significance of these incidental findings so that patients are not needlessly excluded from kidney donation.

Original languageEnglish (US)
Pages (from-to)1826-1829
Number of pages4
JournalJournal of Urology
Volume177
Issue number5
DOIs
StatePublished - May 2007
Externally publishedYes

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Angiography
Tissue Donors
Kidney
Tomography
Urography
Living Donors
Emission-Computed Tomography
Donor Selection
Incidental Findings
Radionuclide Imaging

Keywords

  • angiography
  • digital subtraction
  • kidney
  • kidney transplantation
  • living donors
  • nephrectomy

ASJC Scopus subject areas

  • Urology

Cite this

Strang, A. M., Lockhart, M. E., Kenney, P. J., Amling, C., Urban, D. A., El-Galley, R., ... Kolettis, P. N. (2007). Computerized Tomographic Angiography for Renal Donor Evaluation Leads to a Higher Exclusion Rate. Journal of Urology, 177(5), 1826-1829. https://doi.org/10.1016/j.juro.2007.01.007

Computerized Tomographic Angiography for Renal Donor Evaluation Leads to a Higher Exclusion Rate. / Strang, Andrew M.; Lockhart, Mark E.; Kenney, Philip J.; Amling, Christopher; Urban, Donald A.; El-Galley, Rizk; Burns, John R.; Colli, Jan L.; Hammontree, Lee N.; Kolettis, Peter N.

In: Journal of Urology, Vol. 177, No. 5, 05.2007, p. 1826-1829.

Research output: Contribution to journalArticle

Strang, AM, Lockhart, ME, Kenney, PJ, Amling, C, Urban, DA, El-Galley, R, Burns, JR, Colli, JL, Hammontree, LN & Kolettis, PN 2007, 'Computerized Tomographic Angiography for Renal Donor Evaluation Leads to a Higher Exclusion Rate', Journal of Urology, vol. 177, no. 5, pp. 1826-1829. https://doi.org/10.1016/j.juro.2007.01.007
Strang, Andrew M. ; Lockhart, Mark E. ; Kenney, Philip J. ; Amling, Christopher ; Urban, Donald A. ; El-Galley, Rizk ; Burns, John R. ; Colli, Jan L. ; Hammontree, Lee N. ; Kolettis, Peter N. / Computerized Tomographic Angiography for Renal Donor Evaluation Leads to a Higher Exclusion Rate. In: Journal of Urology. 2007 ; Vol. 177, No. 5. pp. 1826-1829.
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abstract = "Purpose: We compared the exclusion rate for potential living renal donors evaluated with computerized tomography angiography and radionuclide renal scintigraphy (renal scan) vs excretory urogram, renal scan and renal arteriography. Materials and Methods: From March 2004 through February 2006, 603 consecutive patients were evaluated as potential living renal donors. From March 2004 through February 2005, 270 consecutive patients underwent evaluation with excretory urogram, renal scan and renal angiography (group 1). Of these patients 16 underwent computerized tomography to evaluate abnormalities detected on excretory urogram. From March 2005 through February 2006, 333 consecutive patients underwent evaluation with computerized tomography angiography and renal scan (group 2). The number of patients excluded for medical reasons and/or radiographic abnormalities was determined for the 2 groups. Results: More than twice as many patients evaluated with computerized tomography were excluded. In group 1, 7{\%} of patients (20 of 270) were excluded from donation due to radiographic findings vs 16{\%} (53 of 333) in group 2 (p = 0.0016). Of the patients 26{\%} and 23{\%} were excluded from renal donation for medical reasons in groups 1 and 2, respectively (p = 0.5059). Conclusions: Multidetector row computerized tomography angiography increases the detection of incidental radiographic abnormalities as well as the renal donor exclusion rate. The increased sensitivity of computerized tomography angiography has created a dilemma for those determining patient eligibility for kidney donation because the clinical significance of many of these findings is unclear. Additional studies should address the significance of these incidental findings so that patients are not needlessly excluded from kidney donation.",
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AU - Strang, Andrew M.

AU - Lockhart, Mark E.

AU - Kenney, Philip J.

AU - Amling, Christopher

AU - Urban, Donald A.

AU - El-Galley, Rizk

AU - Burns, John R.

AU - Colli, Jan L.

AU - Hammontree, Lee N.

AU - Kolettis, Peter N.

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N2 - Purpose: We compared the exclusion rate for potential living renal donors evaluated with computerized tomography angiography and radionuclide renal scintigraphy (renal scan) vs excretory urogram, renal scan and renal arteriography. Materials and Methods: From March 2004 through February 2006, 603 consecutive patients were evaluated as potential living renal donors. From March 2004 through February 2005, 270 consecutive patients underwent evaluation with excretory urogram, renal scan and renal angiography (group 1). Of these patients 16 underwent computerized tomography to evaluate abnormalities detected on excretory urogram. From March 2005 through February 2006, 333 consecutive patients underwent evaluation with computerized tomography angiography and renal scan (group 2). The number of patients excluded for medical reasons and/or radiographic abnormalities was determined for the 2 groups. Results: More than twice as many patients evaluated with computerized tomography were excluded. In group 1, 7% of patients (20 of 270) were excluded from donation due to radiographic findings vs 16% (53 of 333) in group 2 (p = 0.0016). Of the patients 26% and 23% were excluded from renal donation for medical reasons in groups 1 and 2, respectively (p = 0.5059). Conclusions: Multidetector row computerized tomography angiography increases the detection of incidental radiographic abnormalities as well as the renal donor exclusion rate. The increased sensitivity of computerized tomography angiography has created a dilemma for those determining patient eligibility for kidney donation because the clinical significance of many of these findings is unclear. Additional studies should address the significance of these incidental findings so that patients are not needlessly excluded from kidney donation.

AB - Purpose: We compared the exclusion rate for potential living renal donors evaluated with computerized tomography angiography and radionuclide renal scintigraphy (renal scan) vs excretory urogram, renal scan and renal arteriography. Materials and Methods: From March 2004 through February 2006, 603 consecutive patients were evaluated as potential living renal donors. From March 2004 through February 2005, 270 consecutive patients underwent evaluation with excretory urogram, renal scan and renal angiography (group 1). Of these patients 16 underwent computerized tomography to evaluate abnormalities detected on excretory urogram. From March 2005 through February 2006, 333 consecutive patients underwent evaluation with computerized tomography angiography and renal scan (group 2). The number of patients excluded for medical reasons and/or radiographic abnormalities was determined for the 2 groups. Results: More than twice as many patients evaluated with computerized tomography were excluded. In group 1, 7% of patients (20 of 270) were excluded from donation due to radiographic findings vs 16% (53 of 333) in group 2 (p = 0.0016). Of the patients 26% and 23% were excluded from renal donation for medical reasons in groups 1 and 2, respectively (p = 0.5059). Conclusions: Multidetector row computerized tomography angiography increases the detection of incidental radiographic abnormalities as well as the renal donor exclusion rate. The increased sensitivity of computerized tomography angiography has created a dilemma for those determining patient eligibility for kidney donation because the clinical significance of many of these findings is unclear. Additional studies should address the significance of these incidental findings so that patients are not needlessly excluded from kidney donation.

KW - angiography

KW - digital subtraction

KW - kidney

KW - kidney transplantation

KW - living donors

KW - nephrectomy

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