Abstract:

OBJECTIVE: The aim of this study was to evaluate the renal vascular and collecting system variations in living kidney donors using multidetector computed tomography (MDCT) and to compare the data with the findings detected during retroperitoneoscopic donor nephrectomy. MATERIAL AND METHODS: Between January 2015 and October 2021, 652 living donors who underwent retroperitoneoscopic donor nephrectomy at our center and had preoperative MDCT imaging were included in the study. Arterial, venous, and collecting system variations in the kidneys were detected in MDCT, and the results were compared with the intraoperative findings. RESULTS: Left nephrectomy was performed in 72.7% (474 individuals) of the donors, and right nephrectomy was performed on the remaining 178 donors (27.3%). While 99 (15.1%) of the 652 transplanted kidneys had double arteries, 11 (1.6%) had three arteries, and 1 (<1%) had four arteries; early arterial segmentation was detected in 14 (2.1%) kidneys. According to laparoscopic findings, there were double renal veins in 26 (4%) donor kidneys and three renal veins in 3 (0.4%) kidneys. Also structural venous variation was seen in 8 donors and collector system variation was seen in 6 donors. The sensitivity, specificity, positive-negative predictive value and accuracy of MDCT in detecting the presence of accessory arteries were; 97.3%, 98.5%, 93.1%, 99.4% and 98.3%, respectively. Its accuracy in detecting arterial counts was calculated as 98%. The sensitivity, specificity, positive-negative predictive value and accuracy rates of MDCT in detecting numerical variation in veins were; 100%, 99.8%, 96.5%, 100% and 99.8%, respectively. The accuracy in detecting the count of veins was calculated as 99.8%. 100% success was achieved in detecting arterial early segmentation, late venous confluence and collecting system variations. CONCLUSIONS: MDCT performed with the right technique is a very accurate method for the evaluation of renal vascular and collecting system variations in living-donor candidates for kidney transplantation.

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