Role of CT Angiography in Preoperative Vascular Mapping of Potential Renal Donors

Background: CT Angiography is a reliable and non invasive technique for pre operative evaluation of potential kidney donors especially for vascular mapping. The aim of this studyis to evaluate the prevalence of various anatomic variations regarding the renal vessels that can be detected on MDCT. Methods: A descriptive study was conducted in the Radiology Department of CMH, Rawalpindi from 1July 2013 to 31 August 2015. Totally 105 patients who were candidates for kidney donation underwent CT Angiography (16 slice Philips Brilliance). The contrast enhanced scans were achievedby doing arterial and venous phase imaging at 25 and 55 seconds respectively from the start f injection of 100 ml of intravenous contrast at an injection rate of 3-5ml/sec. Multi planar reconstructions along with 3 D volumetric and MIP images were reviewed by an experienced consultant radiologist. Results: Out of 105 potential donors, accessory renal artery was detected in 29(27.6%), accessory renal vein in 9(8.57%). 16 patients (15.23%) had early branching renal artery whereas 8(7.61%) had late confluence of renal vein. Retro aortic and circumaortic renal vein was seen in 3 and 1 patient (2.85% and 0.95%) respectively. Conclusion: CT Angiography should be used as the primary imaging modality for pre operative workup of potential renal donors especially for evaluation of normal as well as variant vascular anatomy thereby eliminating the need for more invasive procedures like catheter angiography.