Please analyse this report and tell is this report normal for kidney transplant?
CLINICAL INFORMATION:Potential renal donor. TECHNIQUE: Reconstructed non- contrast and post contrast CT renal angiogram including arterial, venous and delayed phases. FINDINGS: Right kidney measures 9.8 cm and left kidney measures 10.6 cm in bipolar dimensions. Both kidneys show normal parenchymal enhancement through the arterial and venous phases with excretion of contrast in the delayed phase. A tiny sub 1 mm hyperdensity is seen at inter polar region of left kidney, likely a renal concretion (88 HU). No calculus is seen in right kidney. No mass or hydronephrosis is noted bilaterally. Urinary bladder is well distended with no evidence of any radio dense calculus. Liver, spleen, pancreas, adrenals , stomach , bowel loops, pelvic viscera and soft tissues are unremarkable. A 3.5 x 2.2 cm cystic area is seen adjacent to left uterine wall, could represent a bowel loop or collection. A 7 mm nabothian cyst is seen. No abdominopelvic ascites. No abdominal lymphadenopathy is seen. Thyroid, supraclavicular regions, axilla, mediastinum, heart and great mediastinal vessels are unremarkable. Lungs are clear of any active patch of consolidation or collapse. Couple of sub 5 mm indeterminate nodules are seen in anterior segment of right upper lobe. No size significant pulmonary nodule. No pleural effusion is seen on either side. Osseous review appears unremarkable, without any lytic or destructive lesion. RENAL ARTERY ANATOMY: There is single renal artery on both sides. Diameter of the right renal artery: 6.0 mm. Length of the right renal artery from its origin till 1st segmental branch: 23 mm. Diameter of the left renal artery: 6.0 mm. Length of the left renal artery from its origin till 1st segmental branch: 27 mm. RENAL VENOUS ANATOMY: There is single renal vein bilaterally. Diameter of the right renal vein: 7.5 mm. Length of right renal vein from 1st segmental tributary till right lateral margin of IVC: 8.0 mm. Diameter of left main renal vein: 8.0 mm. Length of left main renal vein from 1st segmental tributary till left lateral margin of aorta: 20 mm. Length of left main renal vein from 1st segmental tributary till left lateral margin of IVC: 40 mm. There is single pelvicalyceal system bilaterally. IMPRESSION: Single renal artery, renal vein and pelvicalyceal system bilaterally. Tiny sub 1 mm left renal concretion. A 3.5 x 2.2 cm cystic area adjacent to left uterine wall, could represent a bowel loop or collection, requiring ultrasound correlation.
CT renal angiogram kidney donor evaluation normal findings criteria 2024
Overall Verdict: Largely Favorable for Kidney Donation - Minor Incidental Findings Only
✅ NORMAL / FAVORABLE FINDINGS
Kidney Size & Parenchyma
| Parameter | This Report | Normal Range |
|---|---|---|
| Right kidney | 9.8 cm | 9-12 cm |
| Left kidney | 10.6 cm | 9-12 cm |
| Enhancement | Normal | Normal arterial + venous + excretory |
| Hydronephrosis | None | None expected |
| Mass/tumor | None | None expected |
Vascular Anatomy (Surgically Important)
| Feature | This Report | Ideal for Donation |
|---|---|---|
| Renal arteries | Single on both sides | Single artery is ideal |
| Right renal artery diameter | 6.0 mm, length 23 mm | Adequate |
| Left renal artery diameter | 6.0 mm, length 27 mm | Adequate |
| Renal veins | Single on both sides | Single vein is ideal |
| Left renal vein length | 40 mm to IVC | >20 mm = good surgical length |
| Pelvicalyceal system | Single bilaterally | Single is ideal |
⚠️ INCIDENTAL FINDINGS - Require Attention
1. Tiny Left Renal Concretion (sub 1 mm, 88 HU)
- This is essentially a micro-calcification or Randall's plaque, measuring less than 1 mm
- The KDIGO Living Donor Guidelines note that about 5-11% of donor candidates have incidental calcifications on CT; sub-1 mm findings are classified as Randall's plaques with uncertain prognostic significance
- Impact on donation: Minimal to none. This does not typically disqualify donation. If the left kidney is donated, the transplant team would factor this in. If a larger stone forms in the donor's remaining kidney, it becomes higher risk with a solitary kidney.
- Recommendation: Metabolic stone workup (urine calcium, oxalate, citrate, uric acid) to rule out stone-forming tendency
2. Cystic Area Adjacent to Left Uterine Wall (3.5 x 2.2 cm)
- Could be a bowel loop or collection - this is a non-specific finding
- Not kidney-related, but needs clarification before donation clearance
- Recommendation: Ultrasound correlation as suggested in the report - likely benign (a pelvic cyst, follicle, or peristaltic bowel), but must be confirmed
3. Nabothian Cyst (7 mm)
- Completely benign - nabothian cysts are mucus retention cysts of the cervix, extremely common in women, no clinical significance
4. Pulmonary Nodules (sub 5 mm, right upper lobe, 2 nodules)
- Described as "indeterminate" - most sub-5 mm pulmonary nodules in otherwise healthy individuals are benign (granulomas, scar tissue)
- Per Fleischner Society guidelines, sub-6 mm nodules in low-risk individuals generally require no follow-up or optional CT at 12 months
- Not a barrier to kidney donation per se, but the transplant team and pulmonologist should be aware
Summary for Donation Suitability
| Category | Status |
|---|---|
| Kidney anatomy | ✅ Normal - both kidneys suitable |
| Vascular anatomy | ✅ Ideal - single artery, vein, and collecting system bilaterally |
| Preferred donation kidney | ✅ Left kidney (longer vein, slightly larger) |
| Stones | ⚠️ Micro-concretion only - needs metabolic workup |
| Pelvic cyst | ⚠️ Needs ultrasound to characterize |
| Lung nodules | ⚠️ Sub-5 mm - likely benign, needs awareness |
| Other organs | ✅ Unremarkable |
Note: This analysis is for informational purposes. The final decision on donor suitability must be made by the transplant nephrology and surgery team after reviewing the complete workup.