The use of spiral computed tomographic angiography for the assessment of living kidney donors

BACKGROUND: Recent reports suggest that spiral computed tomographic (CT) angiography can replace conventional angiography and intravenous urography for the assessment of potential kidney donors. The purpose of this study is to assess the accuracy of spiral CT in potential kidney donor workup. METHODS: Over a period of 1 year, from December 1995 to December 1996, 16 consecutive potential renal donors had intravenous pyelography, percutaneous transfemoral angiography with selective renal angiography and spiral CT angiography. The spiral CT and renal angiograms were assessed independently by two radiologists. The number of renal arteries, presence or absence of renal artery stenoses and associated parenchymal abnormalities were assessed. RESULTS: A total of 39 renal arteries were detected. Conventional transverse scans viewed in a cine loop format detected all 39 vessels, while the maximum intensity projection and shaded surface display demonstrated only 37. All 39 vessels were detected by the catheter angiography. With the exception of one potential donor with fibromuscular dysplasia, 15 donors were accepted. There was 100% accuracy between the two methods of visualization for the renal arteries. A simple renal cyst was noted in both spiral CT and conventional angiogram, while another had gallstones in spiral CT. CONCLUSIONS: Spiral CT angiography performed as an outpatient procedure is less invasive, less expensive, and provides good images of the arterial and venous anatomy. It has the potential to replace conventional catheter angiography and intravenous pyelogram in the assessment of potential renal donors.