Influence of the Interval Between Renal Computed Tomographic Angiography and Kidney Transplantation on Allograft Function: A Prospective, Randomized, Controlled Trial.
Xie L, Wang X, et al.Transplantation Proceedings 2015; 47(10): 2822-2826.
Aims
To examine whether the interval between computed tomographic angiography (CTA) and transplantation affects renal graft function.
Interventions
Recruited pairs were randomly assigned into two groups, and donors underwent renal CTA either at least 60 days before nephrectomy (preemptive CTA group), or within 3 days before nephrectomy (delayed CTA group).
Participants
86 kidney donor pairs aged 18-70 years receiving their first renal transplant from a living, biologically related donor.
Outcomes
Primary outcomes measured were recovery time to normal serum creatinine (sCr) levels, and numbers of patients showing slow graft function or with normal cystatin C at 1 month after transplantation. Secondary outcomes measured included sCr, estimated glomerular filtration rate, proteinuria, acute rejection, and graft failure.
Follow-up
6 months
CET Conclusions
This is an interesting but small RCT from China in which patients have been randomised to have computerised tomographic angiography (CTA) either some three months before transplantation or after admission within three days of transplantation. All the donors were living-related donors. The two groups each included 43 recipients and at six months’ follow-up both groups showed similar renal function and rates of acute rejection but the recipients who had the CTA within three days of transplantation had a greater incidence of proteinuria than the group who had had CTA some three months before. (5 versus 13, p = ·034) Thus the authors conclude that performing renal CTA on living donors immediately before nephrectomy may increase the risk of proteinuria which, of course, could impact on long-term renal allograft function. They point out the weakness of the study namely the small size and relatively short follow-up, and emphasise the need for a bigger study. They also suggest that another form of imaging might be more attractive particularly if needing to be done in the days leading up to the transplant procedure.
Data analysis
Per protocol analysis
Trial registration
Chinese Clinical Trial Registry ChiCTRTRC-11002108