Korean J Transplant.  2023 Nov;37(Suppl 1):S308. 10.4285/ATW2023.F-9171.

Early graft function using predicted donor renal cortical volume with CT image analysis

• Ogasa T
• Nakagawa Y
• Kimura T
• Yamazaki M
• Mizushima K
• Nozaki T
• Watarai Y
• Narumi S
• Horie S

• KMID: 2551937
• DOI: http://doi.org/10.4285/ATW2023.F-9171

Abstract

Background
Recent improvements in image analysis technology have contributed to more accurate diagnosis and treatment in medicine. We performed image analysis of the donor kidney and correlated the results with the recipient’s postoperative renal function.
Methods
This single center, backward looking cohort observational study evaluated 160 pairs of donors and recipients who underwent living donor renal transplantation from April 2020 to December 2021. Percentages were derived from a combination of four donor factors (renal volume and renal cortical volume analyzed using a Volume Analyzer based on computed tomography images, and actual excised kidney weight) and five recipient factors (preoperative weight, ideal weight, height, body surface area, and body mass index). The correlation between the percentage and the serum creatinine of the recipient at 1 month postoperatively was analyzed and a predictive model of serum creatinine was created by multiple regression analysis.
Results
The correlation coefficients between the percentages obtained from the donor and recipient factors, respectively, and the recipients serum creatinine are shown in the figure. Recipients’ serum creatinine correlated more strongly with the renal volume calculated by the analysis than with the actual kidney weight extracted, and even more strongly with the volume of the renal cortex alone. In addition, preoperative body weight was found to be most representative of the recipients reflux volume. The equation for predicting serum creatinine at 1 month postoperatively for the recipient, calculated by multiple regression analysis using the percentage of analyzed renal cortical volume and recipient body weight, was as follows.
Conclusions
Using the renal cortical volume analyzed from the image analysis, we successfully calculated the recipients predicted postoperative renal function at 1 month postoperatively. This result can be used to make decisions in the case of multiple donors, and if the postoperative renal function differs significantly from the predicted value, it can be used as a basis for suspecting some kind of graft trouble.