CT ANGIOGRAPHY OF POTENTIAL RENAL-TRANSPLANT DONORS

Renal transplantation has grown rapidly over the past 30 years, result ing in an inadequate supply of organs to meet the ever-increasing dema nd. This has led to an increase in the number of living-related donors . Advances in imaging technology now allow safe, rapid, and relatively noninvasive evaluation of potential donors. Helical computed tomograp hic (CT) angiography is a fast, minimally invasive procedure that is q uickly becoming the imaging modality of choice for preoperative evalua tion of potential renal transplant donors, Helical CT, combined with l ow-osmolar intravenous contrast materials, has enabled CT angiography to depict arterial and venous anatomy accurately, Between July 1995 an d March 1997, CT angiography was performed in 205 potential renal dono rs. Correlation with surgical findings in 136 donor nephrectomies help ed confirm a high level of accuracy for CT angiography in the assessme nt of the renal vasculature: Sensitivity and specificity for identifyi ng specific vessels was 99.6% and 99.6% for main renal arteries, 76.9% and 89.9% for polar arteries, and 98.7% and 95.5% for main renal vein s, respectively, CT angiography allows the radiologist to provide the transplant surgeon with precise preoperative anatomy of the renal vasc ulature, thus reducing the risks and complications associated with the harvesting procedure and improving the chances for a successful outco me, However, accurate radiologic interpretation depends on the radiolo gist's experience level, attention to detail, and commitment to carefu l image evaluation.