ABSTRACT. This study aims to investigate the accuracy and value of multislice spiral computed tomography (MSCT) angiography in the evaluation of renal artery variation in living donor kidney transplantation. Two hundred seventy-three kidney transplantation donors underwent preoperative MSCT scanning. Two doctors determined the running direction and variation of the renal artery through joint analysis of the preoperative original MSCT image and the recombination image using the blind reading method, compared the imaging results with the intraoperative results, and evaluated the accuracy and application value of MSCT angiography in the evaluation of renal artery variation in living donor kidney transplantation. CT angiography (CTA) can better show the renal artery and its variation. A total of 52 accessory renal arteries were found in the 273 kidney transplant operations, whereas 55 accessory renal arteries were found in preoperative MSCT. Four accessory renal arteries indicated in the MSCT were not found during the operation, and one accessory renal artery found during the operation Renal artery variation in donor kidney transplantation was not indicated in the preoperative MSCT. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MSCT in the diagnosis of accessory renal arteries were 98.1, 98.2, 92.7, 99.5, and 98.2%, respectively. MSCT angiography can sensitively and accurately show the renal artery and its variation in living donor kidney transplantation, and has important clinical value for the formulation of the operative scheme before the transplantation.

Man, 55-year-old, developed Sagliker syndrome (SS) in the course of hemodialysis for end-stage renal disease from 2008, as a result of uncontrolled secondary hyperparathyroidism (SHPT). His medical managements failed and he had no chance of kidney transplantation. Although surgical parathyroidectomy was rejected and the disease development could not be reversed, PTH began to decline and SS progressed slowly under the control of management and guidance in medication treatment. It is possible that such patients can survive with long-time dialysis, but the prevention of severe SHPT is critical.