Influence of the Interval Between Renal Computed Tomographic Angiography and Kidney Transplantation on Allograft Function: A Prospective, Randomized, Controlled Trial

• The time of donors' CTA was not a key problem in the field of kidney transplantation in the past; few surgeons have paid attention to that, and only a retrospective article recorded the difference.
• A prospective study was conducted with more pairs of donor-recipients, significant difference of CTA time between groups, and more detailed clinic data; this research was well-designed before practice.
• There were some innovations about the assessment of allograft recovery, such as recovery time to normal serum creatinine levels, the numbers of recipients who had slow graft function, or normal cystatin C at 1 month. This was a randomized, controlled trial study, the evidence of which was stronger than other studies.

BackgroundComputed tomographic angiography (CTA) requires contrast agents that may cause nephropathy. We wanted to assess whether donors using contrast agents long or immediately before nephrectomy affects recipient allograft function.MethodsPairs of kidney donors and recipients in our center were recruited between May 2012 and October 2014. They were randomly allocated into the preemptive CTA (pCTA) group, in which the donors underwent CTA at least 60 days before nephrectomy, or the delayed CTA (dCTA) group, in which donors underwent CTA within 3 days before nephrectomy.ResultsBoth groups included 43 recipients. Recovery time to normal serum creatinine levels and the numbers of recipients who had slow graft function or normal cystatin C at 1 month were significantly different between groups. At 6-month follow-up, both groups showed similar serum creatinine levels, estimated glomerular filtration rate, and rates of acute rejection. No participant had graft failure. The pCTA group had a significantly lower number of recipients with proteinuria (5 versus 13, P = .034) and slighter proteinuria (spot urine protein/Cr, 0.09 ± 0.05 versus 0.14 ± 0.07, P = .047).ConclusionsPerforming renal CTA on donors immediately before nephrectomy may increase the risk of proteinuria in recipients, but it does not appear to affect allograft function recovery or survival rate (Chinese Clinical Trial Registration: ChiCTR-TRC-11002108).