2013 - ISODP 2013 Congress

Oral Presentation 8 on Living Donation

15.1 - Estimating differential renal function using ellipsoid approximation of renal volume on CT scan

Presenter: Brian, Blew, Ottawa, Australia
Authors: Laura Nguyen, Fadi Kamal, Brian Blew

Estimating differential renal function using ellipsoid approximation of renal volume on CT scan

Laura Nguyen1, Fadi Kamal1, Brian Blew1

1University of Ottawa/The Ottawa Hospital, Ottawa, ON, Canada

Background: Living renal donors must undergo extensive medical investigations in order to be approved for the donor program. Among other testing, this includes both computed tomography (CT) scans to evaluate vascular anatomy and nuclear medicine renal scans to assess for differential renal function. 

Complex models have been used to calculate precise radiographic measurement of renal volume on CT to estimate differential renal function based on differential renal volumes. Thus, the necessity of the nuclear medicine renal scan can be eliminated, reducing the radiographic burden and time commitment of the potential donor and addressing the ongoing scarcity of necessary radionucleotides. However, these models are rarely used as they are often cost-prohibitive due to the need for proprietary software and they are labor-intensive for radiologists.

Methods: We examined whether a simplified estimation of differential renal volumes based on the ellipsoid formula (renal volume = πldw/6, where l, d, and w represent dimensions of the kidney) using CT scans, may also adequately estimate differential renal function.

Results: Consecutive living renal donors were reviewed retrospectively (n=79). The volume-based estimations of differential renal volume were correlated to differential renal function on nuclear medicine scans (r=0.29, p<0.01). We were able to identify the kidney with the greater function in 53 (67%) of the 79 cases, and in all 8 (100%) of 8 cases in which the difference in differential renal function was clinically significant (>10% difference between kidneys). 

Conclusions: These findings support removal of the nuclear medicine scan from routine assessment of potential kidney donors without the need for expensive radiologic software. Further research looking specifically at potential donors with clinically significant differential renal function between kidneys is required to confirm our findings.

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