RENAL COMPUTED-TOMOGRAPHY WITH 3-DIMENSIONAL ANGIOGRAPHY AND SIMULTANEOUS MEASUREMENT OF PLASMA CONTRAST CLEARANCE REDUCE THE INVASIVENESS AND COST OF EVALUATING LIVING RENAL DONOR CANDIDATES

Renal computed tomography (CT), S-dimensional CT angiography (3D-CTA), and simultaneous measurement of glomerular filtration rate (GFR) by x -ray fluorescence determination of plasma contrast clearance (PCC) are alternatives to intravenous urography (IVU), renal arteriography (RA) , and 24-hr urine creatinine clearance (CrCl) for evaluation of renal structure and function in living renal donor (LRD) candidates. To dete rmine if CT, SD-CTA, and PCC provide data comparable to TW, RA, and Cr Cl, both methods were used to evaluate 23 LRD candidates. Costs were a lso compared. Conventional RA identified 19 accessory arteries and one case of medial fibroplasia. Each of these anomalous vessels was recog nized on 3D-CTA. Venous anatomy was more clearly delineated on 3D-CTA than the venous phase of conventional RA. CT demonstrated 3 benign cys ts and a single, small intraparenchymal calcification in 3 renal units . CFRs measured by PCC and CrCl were 91+/-4 and 132+/-7 ml/min/1.73m(2 ), respectively (r=0.64, P<0.05). Total cost for CT/3D-CTA/PCC was 46% less than that of IVU/RA/CrCl and 40% less than RA/CrCl. CT/3D-CTA/PC C provided reliable structural and functional data at substantially le ss cost, discomfort, and inconvenience to the living renal donor candi date. As such, CT/3D-CTA/PCC is superior to conventional methods for e valuation of the living renal donor candidate.