Renal standard texts
Pre-operative donor assessment
| Text to copy and insert, optimised for Sectra standard report texts. Click to expand. |
|
Auto-inserted clinical details: Report: |
| Heading | Options | Reason |
|---|---|---|
| Renal stones: | Yes/No. | This is a relative contraindication |
| Renal lesions: | Yes/No. Type: | Some centres decline donors if a small angiomyolipoma or even a single cyst is present, in most cases are renal tumour is a contraindication |
| Vascular disease: | Yes/No. Details: | Relevant or elsewhere severe atheromatous disease or fibromuscular dysplasia are contraindications, though endarterectomy and grafting may make a kidney suitable for harvest provided a normal kidney remains. |
| Number of renal arteries | Left: Right: | Hilar, polar and capsular arteries may be present and an increased number may shift the preference to harvest the contralateral side |
| Size (diameter of) accessory renal arteries | Left: Right: | <2 mm polar arteries may be clipped. |
| Branching pattern of renal arteries: | Left: Early/Normal. Right: Early/Normal. | Required for surgical planning |
| Distance to branch point: | Left: Right: Right from lateral edge of IVC: | The right from lateral edge of IVC may be negative if it branches behind the IVC |
| Number of renal veins: | Left: Right: | Required for surgical planning |
| Confluence of renal veins: | Late/Normal. | Required for surgical planning |
| Distance of confluence to IVC: | Left: Left from lateral edge of aorta: Right: | The distance of the left confluence from the aorta may be marked as negative if the confluence is late e.g. -1 cm |
| Course of renal veins: | Retroaortic/Circumaortic/Normal. | Note of retroaortic and circumaortic renal veins is important to aid surgical planning in nephrectomy and retroperitoneal surgery |
| Ureters: | Duplex/Normal. | This is not a contraindication, but is required to be identified |
| Renal scarring: | Left: Yes/No. Right: Yes/No. Extent: | Also a relative contraindication |
| Renal position: | Normal/Horseshoe/Pelvic/Duplex/Crossed fused ectopia. | Horseshoe kidney and crossed fused ectopia are contraindications to renal donation. |
| During surgery a laprascopic approach is used, usually to harvest the left kidney though minor abnormalities in one kidney may favour that kidney being harvested in order to leave the normal kidney. | ||
References:
1. Ghonge NP, Gadanayak S, Rajakumari V. MDCT evaluation of potential living renal donor, prior to laparoscopic donor nephrectomy: What the transplant surgeon wants to know?. Indian J Radiol Imaging. 2014;24(4):367-78.
2. Mastrocostas K, Chingkoe CM, Pace KT, et al. Computed tomography identified factors that preclude living kidney donation. Can Urol Assoc J. 2018;12(8):276-279.
3. Arévalo Pérez J, Gragera Torres F, Marín Toribio A, Koren Fernández L, Hayoun C, Daimiel Naranjo I. Angio CT assessment of anatomical variants in renal vasculature: its importance in the living donor. Insights Imaging. 2013;4(2):199-211.
4. Thamer Alsulaiman, Stephen Mark, Sarah Armstrong, and David McGregor, “Assessment of Potential Live Kidney Donors and Computed Tomographic Renal Angiograms at Christchurch Hospital,” Advances in Urology, vol. 2016, Article ID 4924320, 4 pages, 2016. https://doi.org/10.1155/2016/4924320.
5. Radiographics. 2010 Nov;30(7):1875-90. doi: 10.1148/rg.307105032. Multidetector CT of living renal donors: lessons learned from surgeons. Sebastià C1, Peri L, Salvador R, Buñesch L, Revuelta I, Alcaraz A, Nicolau C.