Optimizing scintigraphic evaluation of split renal function in living kidney donors using the geometric mean method: a preliminary retrospective study

2015 ◽  
Vol 29 (3) ◽  
pp. 435-441 ◽  
Author(s):  
Sarah Weinberger ◽  
Michael Baeder ◽  
Christian Scheurig-Muenkler ◽  
Ingo Guenter Steffen ◽  
Ahmed Magheli ◽  
...  
BJR|Open ◽  
2019 ◽  
Vol 1 (1) ◽  
pp. 20190025
Author(s):  
Chuthaporn Surawech ◽  
Kewalee Sasiwimonphan

Objective: The purpose of this study was to assess the utility of CT-based renal cortex volume to estimate split renal function (SRF) in pre-transplant living kidney donors and to evaluate its reliability to predict graft function in the recipients. Methods: Our study recruited all adult potential donors who had both Tc-99m-diethylenetriamine pentacetate (DTPA) scintigraphy and CT angiography of the abdominal aorta done before donating their kidney. We compared the correlation between CT-based renal cortex volume combined with kidney function and DTPA scan as well as post-donation kidney function in the recipients. Results: The correlation between CT-based split cortex volume and DTPA-measured SRF before transplantation was strong (intraclass correlation coefficient = 0.954–0.968). The inter-rater reliability of two radiologists also showed substantial agreement (intraclass correlation coefficient = 0.97, p < 0.001). In contrast, the correlations between renal cortical volume of donated kidney adjusted to recipient body weight and recipient kidney function was poor at both 2 week and 2 year follow-up. Conclusion: CT-based renal cortex volume combined with pre-operative kidney function appears to be precise and reproducible to evaluate pre-transplant SRF. Nevertheless, the prediction of recipient graft function needs to be further investigated to ensure a good outcome. Advances in knowledge: This method is practicable for all potential donors who undergo kidney transplantation in terms of streamline donor workup without compromising information.


2011 ◽  
Vol 26 (7) ◽  
pp. 2377-2381 ◽  
Author(s):  
I. Fehrman-Ekholm ◽  
N. Kvarnstrom ◽  
J. M. Softeland ◽  
A. Lennerling ◽  
M. Rizell ◽  
...  

2010 ◽  
Vol 24 (3) ◽  
pp. 189-195 ◽  
Author(s):  
Chihoko Miyazaki ◽  
Hiroshi Harada ◽  
Noriyuki Shuke ◽  
Atsutaka Okizaki ◽  
Masayoshi Miura ◽  
...  

2016 ◽  
Vol 15 (3) ◽  
pp. e83 ◽  
Author(s):  
S. Keito ◽  
K. Okamoto ◽  
K. Ozaki ◽  
T. Tsujioka ◽  
H. Iio ◽  
...  

2018 ◽  
Vol 29 (4) ◽  
pp. 1309-1316 ◽  
Author(s):  
Mona D. Doshi ◽  
Mariella Ortigosa-Goggins ◽  
Amit X. Garg ◽  
Lihua Li ◽  
Emilio D. Poggio ◽  
...  

Black living kidney donors are at higher risk of developing kidney disease than white donors. We examined the effect of the APOL1 high-risk genotype on postdonation renal function in black living kidney donors and evaluated whether this genotype alters the association between donation and donor outcome. We grouped 136 black living kidney donors as APOL1 high-risk (two risk alleles; n=19; 14%) or low-risk (one or zero risk alleles; n=117; 86%) genotype. Predonation characteristics were similar between groups, except for lower mean±SD baseline eGFR (CKD-EPI equation) in donors with the APOL1 high-risk genotype (98±17 versus 108±20 ml/min per 1.73 m2; P=0.04). At a median of 12 years after donation, donors with the APOL1 high-risk genotype had lower eGFR (57±18 versus 67±15 ml/min per 1.73 m2; P=0.02) and faster decline in eGFR after adjusting for predonation eGFR (1.19; 95% confidence interval, 0 to 2.3 versus 0.4; 95% confidence interval, 0.1 to 0.7 ml/min per 1.73 m2 per year, P=0.02). Two donors developed ESRD; both carried the APOL1 high-risk genotype. In a subgroup of 115 donors matched to 115 nondonors by APOL1 genotype, we did not find a difference between groups in the rate of eGFR decline (P=0.39) or any statistical interaction by APOL1 status (P=0.92). In conclusion, APOL1 high-risk genotype in black living kidney donors associated with greater decline in postdonation kidney function. Trajectory of renal function was similar between donors and nondonors. The association between APOL1 high-risk genotype and poor renal outcomes in kidney donors requires validation in a larger study.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Akihiro Okubo ◽  
Hideki Yokoi ◽  
Kaoru Sakai ◽  
Takeshi Matsubara ◽  
Motoko Yanagita

Abstract Background and Aims Renal function decreases with aging. Aging is associated with significant changes in structure and function of the kidney. On the macrostructural level, kidney cortical volume decreases, therefore total kidney volume (TKV) also decreases with aging. On the microstructural level, the number of glomerulosclerosis increases, therefore nephron number decreases with aging. Some reports show that the decline of TKV and nephron number is accompanied by a reduction in renal function. However, in the field of living kidney transplantation, TKV and glomerulosclerosis are not fully evaluated as factors influencing the donor’s post-transplant renal function. Living kidney transplantation is an established renal replacement therapy for end-stage renal disease patients. To predict living kidney recipient’s renal function, one-hour protocol biopsy is conducted during the operation. From one-hour protocol biopsy, donor’s pathophysiological findings such as glomerulosclerosis can be evaluated. In this study, we evaluated the correlation of potential influencing factors including TKV and glomerulosclerosis with pre- and post-transplant renal function in living kidney donors. Method This is a retrospective study including all 37 living related kidney donors seen at Kyoto University Hospital from January 2013 to April 2019. Estimated glomerular filtration rate (eGFR) was calculated using equation for Japanese population from serum creatinine levels at pre- and post-transplant. TKV was calculated from the 3D volume-rendered images of enhanced CT (=π/6×length×width×thickness), and adjusted to standard body surface area (BSA) by individual BSA. The ratio of number of non-glomerulosclerosis per that of whole glomeruli (non-GS) was evaluated by protocol renal biopsy at one hour after renal reperfusion. This study protocol was approved by the Ethics Committee on human research of the Graduate School of Medicine, Kyoto University. Results We evaluated 37 living kidney donors (35.1% male, mean age 58.2 ± 12.0 years). Mean pre-transplant eGFR was 75.7 ± 12.1 ml/min/1.73m2, mean post-transplant eGFR; 44.9 ± 7.75 ml/min/1.73m2, adjusted TKV (aTKV); 349.3 ± 58.4 ml, and non-GS; 0.892 ± 0.086. Pre-transplant eGFR was associated with aTKV and aTKV×nonGS (r=0.525, 0.569 respectively, p&lt;0.01). Post-transplant eGFR was associated with age (≧65 years old, p&lt;0.01), aTKV, non-GS, and aTKV×non-GS (r=0.527, 0.344, 0.626 respectively, p&lt;0.05). The rate of eGFR decline was associated with age (≧65 years old, p=0.044), but not with aTKV and non-GS, aTKV×non-GS. Conclusion These results suggest that non-GS and age are correlated with post-transplant renal function but not pre-transplant renal function in living kidney donor, and the decline rate of eGFR are correlated with age.


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