PuSH - Publication Server of Helmholtz Zentrum München: Contrast-enhanced MRI for simultaneous evaluation of renal morphology and split renal function in living kidney donor candidates.

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Krumm, P.* ; Hupka, T.* ; Haußmann, F.* ; Dittmann, H.* ; Mühlbacher, T. ; Nadalin, S.* ; Königsrainer, A.* ; Nikolaou, K.* ; Heyne, N. ; Kramer, U.* ; Guthoff, M.

Contrast-enhanced MRI for simultaneous evaluation of renal morphology and split renal function in living kidney donor candidates.

Eur. J. Radiol. 142:109864 (2021)

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PURPOSE: The evaluation process of potential living kidney donors focusses on renal anatomy and split renal function. This study aimed to evaluate a magnetic resonance imaging (MRI)-based approach for simultaneous evaluation of both and its impact on clinical decision making. METHOD: Over a 3-year period, 65 potential living kidney donors were consecutively enrolled. The MRI protocol was extended by MR-nephrography to measure split renal function. Standard DTPA-scintigraphy was used for functional comparison. RESULTS: Split renal function showed no systematic bias between the two methods (mean difference 0.3%, p = 0.08). Both methods would have yielded the same clinical decision for donor nephrectomy in 75% of the patients. In 25 % of the patients, one method indicated a relevant side difference while the other did not, and a different clinical decision could have been made based on split renal function alone. CONCLUSIONS: MRI proved eligible for comprehensive living kidney donor evaluation and non-inferior to scintigraphy for determining split renal function. In clinical decision making, these two methods would have resulted in the same side for donor nephrectomy in a large proportion of potential donors. Whether MRN will be implemented in clinical practice depends on transplant centre infrastructure and policy.

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