Open AccessVolume matters: CT ‐based renal cortex volume measurement in the evaluation of living kidney donors
Author(s) -
Halleck Fabian,
Diederichs Gerd,
Koehlitz Torsten,
Slowinski Torsten,
Engelken Florian,
Liefeldt Lutz,
Friedersdorff Frank,
Fuller T. Florian,
Magheli Ahmed,
Neumayer HansH.,
Budde Klemens,
Waiser Johannes
Publication year - 2013
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12195
Subject(s) - medicine , renal cortex , renal function , urology , creatinine , kidney , transplantation , cortex (anatomy) , kidney transplantation , nuclear medicine , biology , neuroscience
Summary Currently, no international standard for the pre‐transplant evaluation of living donor renal function exists. Following a standardized questionnaire on current practice in all Eurotransplant (ET) centers, we compared a new CT‐based technique to measure renal cortex volume with our standard of DTPA‐clearance combined with MAG3‐scintigraphy (DTPA × MAG3) and with creatinine‐based methods in 167 consecutive living kidney donors. Most ET centers use creatinine‐clearance (64%) to measure total renal function and radioistopic methods (82%) to assess split renal function. Before transplantation, CT‐measured total cortex volume ( r = 0.67; P < 0.001) and estimated GFR using the Cockcroft‐Gault formula [ eGFR (CG)] ( r = 0.55; P < 0.001) showed the strongest correlation with DTPA‐clearance. In contrast, the correlation between DTPA‐clearance and creatinine clearance was weak ( r = 0.21; P = 0.02). A strong correlation was observed between CT‐measured split cortex volume and MAG3‐measured split renal function ( r = 0.93; P < 0.001). A strong correlation was also found between pre‐transplant split renal function assessed by eGFR (CG) together with cortex volume measurement and post‐transplant eGFR (CG) of both, the donor ( r = 0.83; P < 0.001) and the recipient ( r = 0.75; P < 0.001). In conclusion CT‐based assessment of renal cortex volume bears the potential to substitute existing methods to assess pre‐transplant living donor split renal function.