Abstract: FR-PO1135
Structural and Functional Responses After Donor Nephrectomy Using Noncontrast, Multiparametric MRI
Session Information
- Transplantation: Clinical - Transplant Access, Recipient Evaluation, Living Donors, Pregnancy, and More
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Powell, Emily, The University of Texas at Austin, Austin, Texas, United States
- Margain, Corina, The University of Texas at Austin, Austin, Texas, United States
- Wang, Jiachen, The University of Texas at Austin, Austin, Texas, United States
- Blackwell, Lisa M., The University of Texas at Austin Dell Medical School, Austin, Texas, United States
- Adler, Joel Thomas, The University of Texas at Austin Dell Medical School, Austin, Texas, United States
- Bush, Adam, The University of Texas at Austin, Austin, Texas, United States
Group or Team Name
- Translational Cardiovascular Imaging (TCI) Lab
Background
Pre-operative evaluation of prospective living kidney donors is performed to minimize risk of short and long-term morbidity. Multiparametric (mp)MRI is rarely used for donor evaluation but enables quantification of structural (volume [TVK], cortical thickness) and functional (renal blood flow [RBF], oxygenation, diffusion) indices without exogenous contrast. We sought to characterize structural and functional responses to donor nephrectomy using mpMRI.
Methods
Five living kidney donors (3F, median age 38 (IQR 30.75-54.25)) underwent MRI (3T Vida) exams two weeks prior to and 6 months (M) following donor nephrectomy. The imaging protocol included T1-weighted anatomical scans, phase-contrast, diffusion tensor imaging, and T2* mapping, and CKD-EPI 2021 was used to calculate eGFR.
Results
eGFR decreased significantly from pre-operatively to 6M post-operatively. Compensatory hypertrophy and hyperemia were observed in the contralateral (CL) kidney, reflected by increased kidney volume and RBF, respectively. The magnitude of hypertrophic and hyperemic response was positively associated with six-month eGFR, although these associations were not statistically significant in this pilot cohort. Parameters with significantly different pre- to post-operative values are indicated by * in Table 1.
Conclusion
Hypertrophy and hyperemia occur following donor nephrectomy and are readily captured by non-contrast mpMRI. If validated in larger cohorts, mpMRI-based assessment of renal adaptation could improve living donor evaluation, identify risk factors for poor recovery, and help prevent future kidney-related morbidity.
| Pre-Operative | 6M Post-Op | 6M Post-Op (%Δ) | |
| eGFR (mL/min/1.73m2) Creatinine (mg/dL) Systolic BP (mmHg) Diastolic BP (mmHg) Mean Arterial Pressure (mmHg) TKV - Global (mL) TKV - CL (mL) Cortical Thickness - Global (mm) Cortical Thickness - CL (mm) RBF - Global (mL/min) RBF - CL (mL/min) Cortical R2* - Global (ms) Cortical R2* - CL (ms) Medullary R2* - Global (ms) Medullary R2* - CL (ms) Cortical ADC - Global (mm/s2 x10-3) Cortical ADC - CL (mm/s2 x10-3) Medullary ADC - Global (mm/s2 x10-3) Medullary ADC - CL (mm/s2 x10-3) Cortical FA - Global Cortical FA - CL Medullary FA - Global Medullary FA - CL | 104 ± 21.1 0.80 ± 0.1 119 ± 11.4 71.0 ± 14.4 86.9 ± 12.7 269 ± 57.2 134 ± 27.1 6.65 ± 1.0 6.95 ± 1.0 913 ± 309 356 ± 190 58.3 ± 1.0 57.8 ± 2.5 37.6 ± 1.5 38.1 ± 2.8 2.39 ± 0.1 2.39 ± 0.2 2.01 ± 0.2 2.05 ± 0.2 0.219 ± 0.04 0.202 ± 0.03 0.528 ± 0.08 0.508 ± 0.07 | 69.8 ± 20.5 1.20 ± 0.3 122 ± 11.8 76.6 ± 5.8 91.7 ± 7.1 168 ± 19.4 7.23 ± 1.13 612 ± 201 58.6 ± 7.3 36.1 ± 6.98 2.41 ± 0.2 2.22 ± 0.29 0.206 ± 0.04 0.531 ± 0.03 | -33.9 ± 8.0* 47.7 ± 13.9* 3.45 ± 12.6 12.1 ± 27.9 7.55 ± 19.3 -36.6 ± 10.8* 27.3 ± 10.8* 8.71 ± 3.94 4.17 ± 8.31 -25.1 ± 12.5* 89.1 ± 48.3* 0.619 ± 12.8 1.22 ± 9.35 -3.99 ± 10.7 -4.83 ± 13.5 1.34 ± 8.42 1.19 ± 0.25 11.2 ± 17.5 8.92 ± 16.4 -2.79 ± 23.3 2.71 ± 7.69 2.06 ± 16.3 5.69 ± 12.4 |
Funding
- NIDDK Support