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Genitourinary ❯ Renal Donor CT

ProblemEvaluate a patient to be a potential renal donor
Protocol

The organization that is responsible for defining protocols for renal donors requires a 4 phase study. This includes;

  1. Non contrast CT thru the kidneys (look for renal calculi)
  2. Arterial phase imaging from diaphragm thru the iliac crests (arterial map)
  3. Venous phase imaging thru the kidneys (venous map and to look for potential tumor)
  4. Excretory phase imaging thru the pelvis from above the kidneys (appearance of renal pelvis and ureters)
  5. Measurement on delayed phase imaging of renal length (off sagittal view) and then renal volumes
Pearls
  1. 3D mapping with VRT and MIP is critical for detecting accessory renal arteries and defining their course
  2. Renal harvesting in done laprascopically and ideally the left kidney is removed.
  3. A guiding principle is to leave the donor with the best kidney possible
  4. Counting the number of renal arteries and veins is critical and is best done with 3D maps
  5. We routinely create thin  (<1mm) and thick (3mm) axial images
  6. Small accessory renal arteries are routinely missed on axial images especially if 3mm sections are used

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