Renal Transplantation

Original Article

Grand J Urol 2022;2(2):053-057, DOI: 10.5505/GJU.2022.70288

Is Computed Tomography an Alternative to Scintigraphy for Preoperative Evaluation of Living Kidney Donor Split Renal Function?

Bekir Voyvoda, Nuray Voyvoda, Omur Memik, Onur Karsli

Objective: This study aimed to evaluate whether computed tomography (CT) can replace scintigraphy for the preoperative evaluation of split renal function (SRF) and to determine the agreement between different CT volumetric measurement methods used so as to demonstrate this function. Materials and Methods: The split renal function (SRF) percentage of living kidney donor candidates was determined by diethylenetriamine pentaacetic acid (DTPA) perfusion scintigraphy. The modified ellipsoid volume (MELV), semi-automatic total kidney volume (STKV) and semi-automatic renal cortex volume (SRCV) of the candidates who underwent contrast-enhanced CT were measured and the percentages of both kidney volumes were calculated. The inter-method agreement was evaluated using Pearson's correlation test and the Bland-Altman plot test. Results: There was no correlation between the right and left kidney SRF and MELV (r=-0.033 and r=-0.092), MELV% (r=0.076 and r=0.076), STKV (r=-0.005 and r=-0.120), STKV% (r=0.175 and r=0.172), SRCV (r=-0.001 and r=0.130) and SRCV% (r=0.205 and r=0.183). There were significant correlations between the right MELV and STKV (r=0.855) and SRCV (r=0.813), and between the left MELV and STKV (r=0.787) and SRCV (r=0.770). Conclusion: Although CT provided detailed preoperative anatomical information, volumetric measurements did not show agreement with SRF. The agreement of each 3 volumetric examinations within themselves made us think that disagreement with SRF was independent of the volumetric method chosen.

Grand J Urol 2021;1(3):109-115, DOI: 10.5222/GJU.2021.75047

Coronavirus Disease 2019 in Kidney Transplant Recipients: Our Single Center Experiences

Serdar Karadag, Ramazan Ugur, Emre Sam, Mithat Eksi, Yunus Colakoglu, Kadriye Kart Yasar

Objective: To investigate whether tacrolimus (Tac), mycophenolate mofetil (MMF), mycophenolic acid (MPA), prednisolone (Pred) and methylprednisolone (MP) are affect the COVID-19 pathogenesis and on its progression in kidney transplantation recipients diagnosed with COVID-19 patients. Materials and Methods: Among patients hospitalized due to COVID-19, patients who had kidney transplantation were retrospectively detected on the online database of our center. Referral complaints, laboratory and radiological data at referral, applied treatment protocols, and ultimate conditions of the patients were documented. Results: Among the total of 11 patients, 73% (8) were male and 27% (3) were female. The mean age was 49.63 (27-71). Hypertension and diabetes mellitus were the most common comorbid diseases. The most common symptoms were coughing, fever and exhaustion-fatigue. High serum reactive protein and lymphopenia were detected in almost all patients. Acute renal failure was observed in seven patients (73%). While all patients were using Tac and Pred, nine patients (82%) were using MMF and two patients (18%) were using MPA. Hydroxychloroquine, favipiravir, and azithromycin were treatments for COVID-19. RT-PCR results of 11 patients were positive in 7 and negative in 4 patients. The mean hospital stay of the discharged patients was 8.8 days. Eight patients recovered and were discharged, treatment of two intubated patients continues in intensive care unit and one patient died. Conclusion: Clinical characteristics of COVID-19 in kidney transplanted patients are similar to the general population and it should be kept in mind that the disease occurs with moderate-severe pneumonia in this patient group. Disease progress can be stopped through early treatment.