Helical CT angiography in evaluation of live kidney donors

Background. Live kidney donor evaluation mandates anatomical and functional assessment of the donor kidney. Helical computed tomography (CT) with adva nced 3-D techniques provides detailed description of the vascular, parenchy mal, and collecting system. Methods. We compared the accuracy of helical CT angiography with intra-oper ative findings in the evaluation of 102 live kidney donors. Results. Identification of vascular anomalies was best on direct viewing of the axial images using interactive scrolling through the images and cine-l oop paging. In 204 kidneys evaluated, a single renal artery was present in 74.5% and a single renal vein in 87.5%. Multiple renal arteries were more c ommon on the left side (31%) vs the right side (20%). Early branching of th e arteries was seen with equal frequency (approximate to 10%) on either sid e. Multiple renal veins were more often on the right side (20%) vs the left side (5%), and one patient was found to have double inferior vena cava. CT angiographic, findings were concordant with the intra-operative findings i n 97% of the cases, missing a small renal vein, an accessory artery that wa s visualized in retrospect, and a very early branch that was read as access ory artery. CT also revealed cortical cysts (four cases), duplex collecting system (two cases), hydronephrosis (one case), renal stone (one; case), an d liver haemangioma (two cases). Conclusion. CT angiography is highly accurate for detecting vascular anomal ies, and providing anatomical information. It may serve as the primary tool for donor evaluation.