Multidetector Computed Tomography Angiography for Preoperative Anatomical and Functional Assessment of Living Renal Donors: Correlation With Surgical Findings and Renal Scintigraphy

Background Living donor renal transplantation is the most common treatment for end-stage renal disease, and correct donor evaluation is mandatory to ensure safety and improve outcomes. Multidetector computed tomography angiography offers high-resolution anatomical assessment and potential functional evaluation within a single imaging session. Aims and objectives The aim and objectives of the study were to analyse multidetector computed tomography accuracy in delineating renal vascular anatomy against surgical findings and compare multidetector computed tomography-derived differential renal function with technetium-99m DTPA (Tc-99m DTPA) scintigraphy. Material and methods Sixty-four living renal donors underwent multidetector computed tomography angiography using a triple-bolus contrast protocol, followed by Tc-99m DTPA renal scintigraphy. Renal arterial and venous anatomy, vascular variants, and collecting system abnormalities were evaluated on multidetector computed tomography. Surgical findings were used as the reference standard for vascular anatomy. Differential renal function calculated from computed tomography was compared with scintigraphy using Pearson correlation and Bland-Altman analysis. Results Multidetector computed tomography angiography correctly identified renal arteries in 98.44% (63/64) of donors and renal veins in 100% (64) of donors. Sensitivity and specificity for arterial variants were 98% and 100%, respectively, and 100% for venous variants. Multidetector computed tomography-derived differential renal function correlated significantly with scintigraphy-derived differential renal function (right kidney: r=0.59, p<0.01; left kidney: r=0.55, p<0.01) with a mean difference of 0.10% and 95% limits of agreement within ±6% for both kidneys. Conclusion Multidetector computed tomography angiography provides the best anatomical detail and shows a moderate agreement with scintigraphy for differential renal function. It is a reliable, comprehensive modality for living donor evaluation in appropriately selected candidates.