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Abstract: PO2071

Comparison of CT Volumetry vs. Nuclear Renography to Predict Remaining Kidney Function After Living Kidney Donation

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Eum, Sang Hun, Seoul Saint Mary's Hospital, Seocho-gu, Seoul, Korea (the Republic of)
  • Lee, Hanbi, Seoul Saint Mary's Hospital, Seocho-gu, Seoul, Korea (the Republic of)
  • Yang, Chul Woo, Seoul Saint Mary's Hospital, Seocho-gu, Seoul, Korea (the Republic of)
  • Chung, Byung ha, Seoul Saint Mary's Hospital, Seocho-gu, Seoul, Korea (the Republic of)
Background

Computed tomography(CT) and nuclear renography are performed to decide kidney procurement. The aim of this study was to compare single kidney(sk) function and single kidney(sk) volume in predicting post-donation kidney function. Further, we aimed to investigate which modality is better to decide which kidney is more appropriate in terms of kidney function recovery, especially when the results were contradictory.

Methods

CT volumetry and nuclear renography from 835 kidney donors were retrospectively included. We investigated correlation between sk-volume and sk-mGFR and the agreement of two modalities. Mismatch was defined as sk-volume higher and sk-mGFR smaller than the other kidney, or vice versa. We compared the predictive value for post-donation kidney function between two modalities in total group and in mismatched group. Based upon decision preference, we compared kidney function recovery between two modalities at 6 months after donation.

Results

Mean baseline estimated GFR was 100.01ml/min/1.73m2. The mean right and left sk-volume were 171.18 and 179.71cm3 and mean right and left sk-mGFR were 53.72 and 53.44ml/min, respectively. 701(83.96%) donated left kidney. Sk-mGFR and sk-volume showed significant correlation(r=0.484, P<0.001) and the results showed significant agreement in Bland-Altman plot and Intraclass correlation coefficient was 0.647(P<0.001). In total group, CT volumetry was superior to nuclear renography in predicting kidney function after donation(1 month: βCT=0.402, P<0.001, βrenography=0.242, P<0.001; 6 months: βCT=0.448, P<0.001, βrenography=0.214, P<0.001) by multivariable linear regression analysis. In mismatched group(326 donors), CT volumetry still outweighed nuclear renography(1 month: βCT=0.453, P<0.001, βrenography=0.259, P<0.001; 6 months: βCT=0.480, P<0.001, βrenography=0.285, P<0.001). When mismatch occured, 260(79.75%) procurements were decided by nuclear renography. Functional recovery was higher in CT volumetry preferred group, although it did not reach statistical significance(33.99% vs 30.09%, P=0.098).

Conclusion

CT volumetry was appropriate to assess single kidney function and it outperformed nuclear renography in predicting kidney function after donation. Therefore, when contradictory results between left and right kidney occur, CT volumetry can be preferred in procurement strategy.