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by Jonathan Colledge
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Pre-operative Donor Assessment


Please note, this is not human-readable and produces a poor quality report. It should only be used for eductaional or machine reading purposes.

Text to copy and insert, optimised for Sectra standard report texts:

Auto-inserted clinical details:
<RequestCaseHistory>
<RequestReason>
Report:
Renal stones: [Yes/No].
Renal lesions: [Yes/No]. Type: []
Vascular disease: [Yes/No]. Details: []
Number of renal arteries: Left: [] Right: []
Size (diameter) of accessory renal arteries: Left: [] Right: []
Branching pattern of renal arteries: Left: [Early/Normal]. Right: [Early/Normal].
Distance to branch point: Left: []. Right: [] Right from lateral edge of IVC [may be -ve].
Number of renal veins: Left: [] Right: []
Confluence of renal veins: [Late/Normal].
Distance of confluence to IVC: Left: []. Left from lateral edge of aorta [May be -ve]. Right: [].
Course of renal veins: [Retroaortic/Circumaortic/Normal].
Ureters: [Duplex/Normal].
Renal scarring: Left: [Yes/No]. Right: [Yes/No]. Extent: []
Renal position: [Normal/Horseshoe/Pelvic/Duplex/Crossed fused ectopia].

Explanatory notes

Heading Options Reason
Renal stones: Yes/No. This is a relative contraindication.
Renal lesions: Yes/No. Type: [] Some centres decline donors if a small angiomyolipoma or even a single cyst is present, in most cases a renal tumour is a contraindication.
Vascular disease: Yes/No. Details: [] Relevant or elsewhere severe atheromatous disease or fibromuscular dysplasia are contraindications, though endarterectomy and grafting may make a kidney suitable for harvest provided a normal kidney remains.
Number of renal arteries: Left: [] Right: [] Hilar, polar and capsular arteries may be present and an increased number may shift the preference to harvest the contralateral side.
Size (diameter) of accessory renal arteries: Left: [] Right: [] <2 mm polar arteries may be clipped.
Branching pattern of renal arteries: Left: Early/Normal. Right: Early/Normal. Required for surgical planning.
Distance to branch point: Left: [] Right: [] Right from lateral edge of IVC [may be -ve]. The right from lateral edge of IVC may be negative if it branches behind the IVC.
Number of renal veins: Left: [] Right: [] Required for surgical planning.
Confluence of renal veins: Late/Normal. Required for surgical planning.
Distance of confluence to IVC: Left: [] Left from lateral edge of aorta [May be -ve]. Right: []. The distance of the left confluence from the aorta may be marked as negative if the confluence is late e.g. -1 cm.
Course of renal veins: Retroaortic/Circumaortic/Normal. Note of retroaortic and circumaortic renal veins is important to aid surgical planning in nephrectomy and retroperitoneal surgery.
Ureters: Duplex/Normal. This is not a contraindication, but is required to be identified.
Renal scarring: Left: Yes/No. Right: Yes/No. Extent: [] Also a relative contraindication.
Renal position: Normal/Horseshoe/Pelvic/Duplex/Crossed fused ectopia. Horseshoe kidney and crossed fused ectopia are contraindications to renal donation. During surgery a laprascopic approach is used, usually to harvest the left kidney though minor abnormalities in one kidney may favour that kidney being harvested in order to leave the normal kidney.

References:

  1. Ghonge NP, Gadanayak S, Rajakumari V. MDCT evaluation of potential living renal donor, prior to laparoscopic donor nephrectomy: What the transplant surgeon wants to know?. Indian J Radiol Imaging. 2014;24(4):367-78.
  2. Mastrocostas K, Chingkoe CM, Pace KT, et al. Computed tomography identified factors that preclude living kidney donation. Can Urol Assoc J. 2018;12(8):276-279.
  3. Arévalo Pérez J, Gragera Torres F, Marín Toribio A, Koren Fernández L, Hayoun C, Daimiel Naranjo I. Angio CT assessment of anatomical variants in renal vasculature: its importance in the living donor. Insights Imaging. 2013;4(2):199-211.
  4. Thamer Alsulaiman, Stephen Mark, Sarah Armstrong, and David McGregor, “Assessment of Potential Live Kidney Donors and Computed Tomographic Renal Angiograms at Christchurch Hospital,” Advances in Urology, vol. 2016, Article ID 4924320, 4 pages, 2016. https://doi.org/10.1155/2016/4924320
  5. Radiographics. 2010 Nov;30(7):1875-90. doi: 10.1148/rg.307105032. Multidetector CT of living renal donors: lessons learned from surgeons. Sebastià C1, Peri L, Salvador R, Buñesch L, Revuelta I, Alcaraz A, Nicolau C.
  6. Nam JK, Park SW, Lee SD, Chung MK. The clinical significance of a retroaortic left renal vein. Korean J Urol. 2010;51(4):276-80.