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      Optimizing Evaluation of Split Renal Function in a Living Kidney Donor Using Scintigraphy and Calculation of the Geometric Mean: A Case Report

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          Within the evaluation process of living kidney donors, split renal function is usually evaluated by renal scintigraphy. Since split renal function measured by conventional posterior scans depends on the position of the kidney, actual suitable donors may be rejected because of an inaccurate examination technique. We report the case of a 28-year-old male living kidney donor. Due to a complex vascular anatomy of the right kidney, only his left kidney was considered eligible for transplantation. In conventional posterior Tc99m-mercapto-acetyltriglycine scintigraphy, the left kidney had a relative function of 60%. A second scintigraphy using anterior and posterior dimercaptosuccinic acid scans with calculation of the geometric mean showed an adapted relative function of the left kidney of 53%, now meeting the inclusion criteria for living kidney donation. This case shows that the geometric mean method using simultaneous anterior and posterior views obtained with a dual-head gamma camera can be a very helpful approach to determine split renal function of potential living kidney donors. Further investigation is necessary to prove the benefit of a general bilateral scan before living kidney donation.

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          Most cited references 14

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          A Report of the Amsterdam Forum On the Care of the Live Kidney Donor

           &NA; (2005)
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            The conditions for which the geometric mean method revealed a more accurate calculation of relative renal function in 99mTc-DMSA scintigraphy.

            (1) To compare the results of calculating relative renal function (RRF) by using only posterior images (POST) with the geometric mean (GM) through both anterior and posterior imaging on dimercaptosuccinic acid (DMSA) scintigraphy. (2) To determine whether there was an age-related difference between them and whether some renal pathologies or asymmetrical renal function cause an error in the RRF calculation by using posterior images only.
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              A report of the Amsterdam Forum on the 48. care of the live kidney donor: Data and Medical Guidelines


                Author and article information

                Case Reports in Nephrology and Dialysis
                S. Karger AG
                January – April 2014
                10 January 2014
                : 4
                : 1
                : 1-4
                Departments of aUrology, bNuclear Medicine and cRadiology, Charité, Berlin, Germany
                Author notes
                *Dr. Sarah Weinberger, Urologische Klinik, Charité Campus Benjamin Franklin, Hindenburgdamm 30, DE-12203 Berlin (Germany), E-Mail
                358007 PMC3934684 Case Rep Nephrol Urol 2014;4:1-4
                © 2014 S. Karger AG, Basel

                Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (, applicable to the online version of the article only. Distribution permitted for non-commercial purposes only. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 3, Pages: 4
                Published: January 2014

                Cardiovascular Medicine, Nephrology

                Geometric mean, Renal function, Scintigraphy, Living kidney donor


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