Multidetector CT of living renal donors: lessons learned from surgeons

Multidetector computed tomography (CT) is the choice technique for preoperative evaluation of living renal donors. Living donor transplantation, as opposed to cadaveric donation, is the best option for recipient and graft survival. The need for kidney transplantation has undergone exponential growth over the past 40 years, and cadaveric donations are inadequate to meet this ever-increasing demand. These factors have led to a continued increase in organ donation from living related donors. From January 2007 to October 2009, 199 potential renal donors were studied in one center with 64-row multidetector CT. Of these candidates, 94 were rejected for donation. The remaining 105 potential donors were evaluated by a multidisciplinary committee, and 101 donor-recipient couples were accepted for renal donation and transplantation. Laparoscopic nephrectomy is the preferred surgical procedure for harvesting kidneys from living donors. Radiologists are responsible for providing accurate anatomic information about the donor's renal parenchyma, arteries, veins, and collecting system. Accurate reporting depends on the radiologist's level of expertise, attention to detail, and commitment to careful image evaluation. Knowledge of the surgical techniques and the difficulties that surgeons face during laparoscopic nephrectomy and renal transplantation is essential for compiling accurate radiologic reports.