Christina Lurie MD, Presenter: Nothing to Disclose

Khalil N. Salman MBBS, Abstract Co-Author: Nothing to Disclose

Bobby Thomas Kalb MD, Abstract Co-Author: Nothing to Disclose

John R. Votaw PhD, Abstract Co-Author: Nothing to Disclose

Diego R. Martin MD, PhD, Abstract Co-Author: Research grant, General Electric Company, Milwaukee, WI Research Consultant, Bayer AG Research Consultant, Bracco Group Research grant, Siemens AG, Erlangen, Germany

To quantitatively assess and compare individual kidney structure and functional status in renal donors and recipients both pre- and postoperatively using magnetic resonance nephrourography (MRNU).

This study was HIPPA compliant and approved by our IRB. Consented donors underwent MRNU  pre- and postoperatively, and the recipient underwent MRNU and renal biopsy 6 months postoperatively. Using a 1.5 Tesla magnet and phased-array surface coils, MRNU protocol includes (1) breath-hold T2-weighted single-shot echo-train coronal, sagittal and axial images, at least one plane performed with fat-suppression; (2)T1-weighted 3D gradient echo (GRE) precontrast axial and coronal fat-suppressed images; and (3)T1-weighted gadolinium (Gd)-enhanced arterial, capillary and delayed-phase images. Multislice regions of interest (ROIs) were created in Analyze v6.0 (Mayo Clinic MN) for the aorta, the native and recipient transplanted kidneys. Bulk renal signal results and kidney volumes were input into a 3-compartment kinetic modeling program (Emory Univ GA), which optimally fits 4 physiological variables including glomerular filtration rate (GFR) to each kidney.

For the transplanted kidneys of the first and second pairs, renal volume increased 21.1% and 16.2%, respectively. GFR of the transplanted kidneys increased 86.1% and 24.4%, and renal blood flow (RBF) increased 5.4% and 10.8%. GFR/Vol [min-1] of the transplanted kidneys increased 50% and 0%, while the RBF/Vol [min-1] decreased 15.4% and 4.3%. For the donors of the first and second pairs, the nontransplanted kidneys demonstrated comparable volume increases of 16.2% and 26.1%, respectively. GFR of the nontransplanted kidneys increased 54.9% and 34%. GFR/Vol [min-1] of 0% and 50%, while RBF/Vol [min-1] decreased 14.8% and 13%. Biopsy of the two transplanted kidneys revealed no acute pathology.

Kidney donation and transplantation requires comprehensive radiologic evaluation of both donor and recipient pre- and postoperatively. MRNU offers assessment and periodic monitoring of structural and functional status for each individual kidney within a single imaging examination without using ionizing radiation.

MRNU provides comprehensive analysis of each kidney in both donor and recipient pre- and postoperatively, further equipping transplant physicians in determining optimum post-transplant intervention.

Lurie, C, Salman, K, Kalb, B, Votaw, J, Martin, D, Quantitative Analysis and Follow-up of Individual Kidney Structure and Function in Living Renal Donors and Respective Recipients, before and after Transplantation.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9015337.html