Jessica Ashley Rotman MD, Presenter: Nothing to Disclose

Paul Masi, Abstract Co-Author: Nothing to Disclose

Robert Spandorfer, Abstract Co-Author: Nothing to Disclose

Carl Ceraolo, Abstract Co-Author: Nothing to Disclose

Ashley Giambrone PhD, Abstract Co-Author: Nothing to Disclose

David Serur MD, Abstract Co-Author: Nothing to Disclose

Choli Hartono MD, Abstract Co-Author: Nothing to Disclose

Krishna Juluru MD, Abstract Co-Author: Nothing to Disclose

Graft mass has been shown to be positively correlated with outcomes in kidney transplants. We investigate the use of semi-automated, CT-based quantification of graft volume as a non-invasive, pre-operative predictor of 12 and 24 month graft function.

In this retrospective study, all transplants over a 3 year period in which donors obtained CT scans for routine pre-operative evaluation were included, and transplants in which recipient outcomes data were unavailable were subsequently excluded. Using a commercially-available reconstruction tool, donated kidney cortical and whole parenchymal volumes (DKV) were measured independently by two observers. Transplant characteristics recorded by chart review included donor/recipient demographics, recipient weight (RW), transplant immunological matching, history of acute rejection, delayed graft function, and/or viral infections, and recipient creatinine values at multiple time points. Intra-class correlation (ICC) of measurements by the two observers was calculated. DKV/RW ratios were correlated with graft function over 24 months and utilized in logistic regression models to calculate odds of developing diminished renal function. 

150 transplants met inclusion/exclusion criteria. Cortical and total parenchymal measurements demonstrated high reproducibility between the two observers (ICC = 0.93-0.94). Unadjusted correlations existed between eGFR and DKV/RW ratio at 12 (R=0.82) and 24 months (R=0.78). After adjusting for transplantation parameters, recipients in the highest DKV/RW ratio tertile had persistently higher mean eGFR at all timepoints over 24 months than recipients in lower tertiles. Recipients in the highest tertile had a significantly reduced risk of developing diminished renal function as compared to recipients in the lowest tertiles at 12 and 24 months post transplant (adjusted OR = 0.15 & 0.10, respectively). 

DKV/RW ratio is a non-invasive, readily-obtained, reproducible parameter that is a predictor of 12 and 24 month renal transplant outcomes. 

Transplant outcomes can be improved by incorporating DKV/RW ratio into the renal donor/recipient selection process. 

Rotman, J, Masi, P, Spandorfer, R, Ceraolo, C, Giambrone, A, Serur, D, Hartono, C, Juluru, K, Semi-Automated Quantification of Donor Kidney Volume Applied to a Predictive Model for Outcomes in Renal Transplantation.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14001948.html