[show abstract][hide abstract] ABSTRACT: Patients with end-stage renal disease (ESRD) have an increased risk of developing renal cell carcinoma (RCC). This retrospective study compared clinical and pathological outcomes of RCC occurring in native kidneys of patients with ESRD (whether they underwent kidney transplantation or not) with those of renal tumors diagnosed in the general population.
The study included a total of 533 patients with RCC. The ESRD cohort included 92 patients with RCC in native kidneys. Of these, 58 and 34 cases were identified before (pre-Tx group) and after kidney transplantation (post-Tx group), respectively. The control group was composed of 441 RCCs diagnosed in the general population. Variables were compared by chi-square and Student's t tests. Cancer-specific survival was assessed by Kaplan-Meier and Cox methods.
The ESRD groups had smaller (P = 0.001), lower-grade, and lower-stage tumors than the non-ESRD group (P = 0.001). The papillary RCC rate was higher in the ESRD groups (P = 0.01). Ten-year cancer-specific survivals were 94.5, 87.9, and 74.6 % in pre-Tx, post-Tx, and non-ESRD patients, respectively (P = 0.003). Mean follow-up was 90.2 months. At multivariate analysis, tumor size (HR = 1.10), pathological stage (HR = 1.46), presence of nodal (HR = 2.22) and visceral metastases (HR = 3.49), and Fuhrman grade (HR = 1.48) were independent adverse prognostic factors for cancer-specific survival.
Native kidney RCCs arising in ESRD patients are lower stage and lower grade as compared to RCCs diagnosed in the general population, and these tumors exhibit favorable clinical and outcome features.
World Journal of Urology 02/2014; · 2.89 Impact Factor
[show abstract][hide abstract] ABSTRACT: Recurrence of idiopathic focal segmental glomerulosclerosis (FSGS) following kidney transplantation occurs in a large percentage of patients. Accurate prediction of recurrence and elucidation of its pathogenesis are major therapeutic goals. To detect differential proteins related to FSGS recurrence, proteomic analysis was performed on plasma and urine samples from 35 transplanted idiopathic FSGS patients, divided into relapsing and nonrelapsing. Several proteins were detected increased in urine of relapsing FSGS patients, including a high molecular weight form of apolipoprotein A-I, named ApoA-Ib, found exclusively in relapsing patients. This finding was verified by Western blot individually in the 35 patients and validated in an independent group of 40 patients with relapsing or nonrelapsing FSGS, plus two additional groups: FSGS-unrelated patients showing different proteinuria levels (n = 30), and familial FSGS transplanted patients (n = 14). In the total of 119 patients studied, the ApoA-Ib form was detected in 13 of the 14 relapsing FSGS patients, and in one of the 61 nonrelapsing patients. Only one of the 30 patients with FSGS-unrelated proteinuria tested positive for ApoA-Ib, and was not detected in familial patients. Urinary ApoA-Ib is associated with relapses in idiopathic FSGS and warrants additional investigation to determine its usefulness as biomarker of relapse following transplantation.
American Journal of Transplantation 12/2012; · 6.19 Impact Factor
[show abstract][hide abstract] ABSTRACT: INTRODUCTION: Continuous erythropoietin receptor activator (C.E.R.A.) effectively enables anemia control in patients with chronic kidney disease, but little information is available in renal transplant recipients. The authors aimed to evaluate the effect of C.E.R.A. under clinical practice conditions on anemia control in renal transplant recipients. METHODS: This was a multicenter, retrospective, observational study carried out in adult renal transplant patients in the immediate posttransplant period and at late posttransplant period receiving C.E.R.A. in clinical practice. Patients' data were retrieved from their medical charts at baseline and months 1, 3, and 6. RESULTS: A total of 318 evaluable patients were enrolled into the study: 32 in the immediate posttransplant period and 286 at late posttransplant period (erythropoiesisstimulating agent [ESA]-naïve, n = 44; converting from other ESAs, n = 242). Patients in the immediate posttransplant period experienced a significant increase in hemoglobin (Hb) levels from baseline to month 1 (9.9±1.5 g/dL vs. 11.5±1.4 g/dL; P< 0.001). ESA-naïve patients showed increasing mean Hb levels from baseline to month 6 (10.1±0.7 g/dL vs. 11.7±1.0 g/dL; P < 0.001) and 94.7% achieved Hb ≥11 g/dL during the study. In patients converted from other ESAs, the percentage of patients with Hb between 11-13 g/dL was maintained from baseline to month 6 with no significant differences (61.0% vs. 62.4%). Mean monthly doses of C.E.R.A. at baseline were 134.4±56.4 μg, 81.3±28.1 μg, and 93.0±44.2 μg in immediate posttransplant, ESA-naïve, and converted patients, respectively. C.E.R.A. was well tolerated. CONCLUSION: C.E.R.A. enables anemia control in renal transplant recipients, allowing target Hb levels to be achieved and maintained with doses even below those described in the Summary of Product Characteristics.
[show abstract][hide abstract] ABSTRACT: Prolonged-release tacrolimus was developed to provide a more convenient once-daily dosing that could improve patient adherence. We conducted a multicenter, prospective, observational, 12-month study to describe the efficacy, safety and patient preference of conversion from tacrolimus twice-daily to once-daily formulation in stable kidney transplant recipients in routine clinical practice. Conversion was made on a 1 mg: 1 mg basis (1 mg: 1.1 mg in patients with trough levels <6 ng/mL). The study included 1832 patients (mean age (± SD): 50.0 ± 13.4 years; 62.7% male). After conversion, a modest reduction in tacrolimus trough levels, necessitating an increase in daily dose, was observed (mean changes at 12 months of -9.1% and +1.24%, respectively; p < 0.0001). Mean glomerular filtration rate did not change significantly (56.5 ± 19.7 mL/min at conversion vs. 55.7 ± 20.6 mL/min at 12 months). Proteinuria, blood pressure, lipid, hepatic and glucose parameters remained stable. Eight patients (0.4%) had acute rejection and 34 patients (1.85%) discontinued treatment. Almost all patients (99.4%) preferred the once-daily formulation, because of less frequent dosing (66%) and improved adherence (34%). In conclusion, at similar doses to twice-daily tacrolimus, once-daily formulation provided stable renal function, a low acute rejection rate, and good tolerability in stable kidney transplant recipients in the routine clinical practice setting.
American Journal of Transplantation 06/2011; 11(9):1965-71. · 6.19 Impact Factor
[show abstract][hide abstract] ABSTRACT: to review our experience in renal retransplantations.
we carried out a retrospective study on 71 patients with retransplantation performed between 1980 and 2005. We studied: the characteristics of the recipient and graft, surgery data, causes of loss of the graft, number of rejects and transplantectomies and, survival of the graft.
the most frequent cause of graft loss was chronic rejection. The causes of first graft loss were not associated with a greater loss of the second graft (p>0.05). The percentage of anti-HLA antibodies increased in the second transplant in comparison to the first (17.23±27.91% vs. 1.21±7.43%) (p=0.001), however, it was not correlated with a significant increase in loss of the second graft (p=0.320). There were no significant differences between the complications of the first and second transplants (p>0.05) and they were not associated with graft loss (p>0.05). The patients with a transplantectomy in the first transplant presented a risk 8.5 times higher of undergoing a second one (p=0.0001; OR: 8.54; CI: 95% 0.941 - 77.501). The most frequent cause of transplantectomies in the second transplant was acute rejection. Acute rejection as a cause for transplantectomy in the first transplant proved to be an independent risk factor of transplantectomy of the second transplant (p=0.009). The mean survival of the second graft was 5.08±4.81 years, higher than the first transplant (p=0.133). The survival of the graft at 1.5 and 10 years was 83%, 75% and 52%, respectively.
the survival of the second transplant was not lower than the first, neither was there an increase in the number of complications.
[show abstract][hide abstract] ABSTRACT: Kidney transplant, the gold standard treatment for chronic kidney disease (CKD), is increasingly complicated by anemia. Once-monthly dosing of methoxy polyethylene glycol-epoetin beta provides stable, sustained hemoglobin levels in CKD patients. The present study evaluated anemia control in recipients treated with methoxy polyethylene glycol-epoetin beta to correct or as conversion treatment from other erythropoiesis-stimulating agents (ESAs).
This observational, retrospective study included kidney transplant patients treated with methoxy polyethylene glycol-epoetin beta according to investigators' clinical practice. Information about demographics, CKD, anemia, blood analyses, treatment, and adverse events were collected from patients' medical charts at baseline as well as months 1, 3, and 6.
From October 2009 to March 2010, the 285 patients in the study included: an overall mean age of 52.8±13.9 years with 146 females (51.2%) and 152 patients (55.1%) in stage 3 CKD. Forty-five patients (15.8%) were in the immediate posttransplant period; 51, naïve- treatment (17.9%) and 189, converted subjects (66.3%). Eighty-two of the converted patients (48.0%) had previously received darbepoietin; 81 (47.4%), epoetin beta; and 8 (4.7%), epoetin alfa. The mean doses of methoxy polyethylene glycol-epoetin beta at baseline were 75.0±22.4 μg per month, 95.8±45.5 μg per month, and 118.9±58.9 μg per month among naïve, converted, and immediate posttransplant patients, respectively. Mean hemoglobin content varied from baseline to month 6, namely 10.2±0.7 versus 11.8±0.9 g/dL in naïve (P<.001) and 11.4±1.3 versus 12.0±1.2 g/dL in converted patients (P=.001). Patients in the immediate posttransplant period showed mean hemoglobin values maintained between 10.4±1.7 g/dL at baseline and 11.5±1.2 g/dL at month 3. The only study-drug-related adverse event was hypertension. No patient died during the study.
These preliminary results suggested that hemoglobin stability can be achieved and maintained after correction or conversion to once-monthly methoxy polyethylene glycol-epoetin beta in kidney recipients. It was well tolerated; the safety profile was that expected and comparable with shorter acting ESAs.
[show abstract][hide abstract] ABSTRACT: Treatment with oral risedronate to prevent bone mineral density (BMD) loss in renal transplant recipients has been shown to be effective. There is no agreement on the optimum moment of introduction or how long it should be continued. The aim was to evaluate the effectiveness of risedronate at doses of 35 mg/week in renal transplant recipients who underwent treatment immediately after transplant.
A randomized clinical trial was performed on 101 renal transplant patients. The study group (52 patients) received 35 mg risedronate weekly, vitamin D, and calcium, whereas the control group (49 patients) received only vitamin D and calcium. At baseline, 3, 6, and 12 months, basic biochemistry and mineral bone metabolic parameters were determined. Vertebra and hip fracture assessment was performed by means of x-ray and DEXA; an intention-to-treat analysis was performed.
Patients in control group showed a significant worsening of BMD (P<0.05) 12 months into the study. At all follow-up points, lumbar BMD of the study group was significantly greater (P<0.05), whereas femoral BMD of those treated with risedronate was only significant at 6-month follow-up (P<0.05). There was a trend of more vascular calcifications and fractures in the control group, but this was not statistically significant.
Weekly oral administration of risedronate immediately after renal transplantation contributes to an improved BMD, particularly in the femoral neck at 6-month follow-up, without major side effects. Long-term follow-up is needed to establish whether oral risedronate has an influence on vascular calcifications and bone fractures.
[show abstract][hide abstract] ABSTRACT: Background. Renal re-transplants are increasing in number, due to many first renal transplant patients coming back to dialysis treatment. There are controversial opinions about the evolution of these re-transplanted patients. The aim of our study is to analyse the prognosis of patients and grafts under a renal re-transplant.Methods. This was a retrospective study of 579 renal re-transplants realized in 15 Spanish different centres in the years 1990, 1994, 1998 and 2002 including all renal re-transplants realized in the above-mentioned centres during the same periods.Results. During the follow-up period, 8.81% of patients died. The actuarial patient survival was 85% at 10 years and 80% at 15 years. Principal reasons of death were the same as normal for the renal transplanted patient: cardiovascular (30.77%), infectious (13.46%) and neoplastic (13.46%). During the period of follow-up, 28.6% of the grafts were lost. The actuarial graft survival was 75% at 10 years and 58% at 15 years. Causes of graft loss are very similar to those described in literature.Conclusion. Renal re-transplant is a kind of substitute renal treatment with excellent clinical results that allow to take it as a first-order modality of treatment when the first renal transplant has failed.
[show abstract][hide abstract] ABSTRACT: This study evaluates the efficacy of low doses of pamidronate after renal transplantation to prevent bone loss in osteopenic patients. Results show that pamidronate is safe and significantly reduced spinal bone loss when administered immediately after renal transplantation.
The purpose of this work is to evaluate the efficacy of two intravenous infusions of pamidronate in the immediate post-transplant period in a renal transplant (RT) population.
In this 12-month, randomized, double-blind, multicenter trial, 39 kidney recipients with diagnosed osteopenia received two doses of 30 mg of disodium pamidronate (n = 24) or placebo (n = 15), at surgery and 3 months post-RT. All patients received calcium and vitamin D. Bone density of the lumbar spine and total femur was measured by dual-energy X-ray absorptiometry (DXA) and X-rays were performed at RT, 6 and 12 months post-RT. Biochemical and hormonal determinations were performed before and after treatment.
Pamidronate significantly reduced spinal bone loss, but no significant benefit was found for the incidence of fractures. Elevated baseline intact parathyroid hormone (iPTH) and bone remodeling markers returned to normal levels 3 months post-RT. However, normal procollagen type I N propeptide (PINP) concentrations were only maintained in the pamidronate group. After RT, a comparable graft function was observed in both groups according to creatinine values, 25-hydroxyvitamin-D (25-OH-D) levels were improved, and serum calcium levels normalized after a transient fall during the first 3 months.
A low dose of pamidronate prevents bone loss in osteopenic patients when administered immediately after RT.
Osteoporosis International 03/2010; 22(1):281-7. · 4.04 Impact Factor
[show abstract][hide abstract] ABSTRACT: We present the details of the first laparoscopic transplantation of a kidney from a living, related donor, performed April 16, 2009. Surgical and functional results were acceptable. Surgical time was 240 min (53 min for vascular suture), with blood loss of 300 cm(3) and a hospital stay of 14 d. Serum creatinine at discharge was 73 mmol/l. Laparoscopic kidney transplantation is a complex technique that requires previous experience in vascular and laparoscopic surgery. As with all novel procedures, technical modifications will be required to formalize its use and detailed comparisons will need to be made with standard procedures.
European Urology 08/2009; 57(1):164-7. · 10.48 Impact Factor
[show abstract][hide abstract] ABSTRACT: m-TOR inhibitors (e.g. sirolimus) are well-tolerated immunosuppressants used in renal transplantation for prophylaxis of organ rejection, and are associated with long-term graft survival. Early use of sirolimus is often advocated by clinicians, but this may be associated with a number of side-effects including impaired wound-healing, lymphoceles and delayed graft function. As transplant clinicians with experience in the use of sirolimus, we believe such side-effects can be limited by tailored clinical management. We present recommendations based on published literature and our clinical experience. Furthermore, guidance is provided on sirolimus use during surgery, both at transplantation and for subsequent operations.
Transplant International 05/2009; 22(7):681-7. · 3.16 Impact Factor
[show abstract][hide abstract] ABSTRACT: The prevalence of traditional cardiovascular risk factors in renal transplantation is high. Studying the evolution of cardiovascular risk factors over time may help us to design better strategies to control them. The relative impact of traditional cardiovascular risk factors on allograft survival and mortality in transplant recipients is not clear. This study was performed to determine the incidence and risk factors for allograft survival and mortality among renal transplant patients.
We enrolled 250 patients who had undergone transplantation between 1980 and 2004. They were followed for various periods, and we analyzed the impact of traditional and nontraditional risk factors on renal allograft survival.
The prevalence of hypertension was >80% during all the follow-up periods. Blood pressure diminished, antihypertensive drug prescription increased, and 15% of patients had adequate blood pressure control during follow-up. The prevalence of pretransplant diabetes mellitus was 6.8%; the incidence of posttransplant diabetes mellitus (PTDM) was 14.2%. The prevalence of PTDM increased over the course of patient evolution. The prevalence of dyslipidemia was in all cases >70%; total cholesterol and low-density lipoprotein (LDL)-cholesterol decreased; prescription of statins increased; and the percentage of patients with good lipid control also increased. The 25% prevalence of active smoking at the time of transplantation decreased to 13.6% at 10 years posttransplantation. The mean patient follow-up was 8 +/- 4.6 years. Sixty-five patients (26%) lost their grafts and 40 (16%) died during follow-up. Donor age, exercise, diastolic blood pressure, renal function, and albumin levels were independent risk factors for graft loss. Charlson comorbidity index at transplantation, recipient and donor ages, exercise, diastolic blood pressure, and LDL-cholesterol posttransplantation were independent risk factors for mortality among renal transplant recipients.
Blood pressure and lipid control improved during follow-up, however, insufficiently among renal transplant patients. The prevalence of diabetes gradually increased, and the incidence of smoking cessation was low. Diastolic blood pressure, exercise, and albuminemia were the most significant modifiable cardiovascular risk factors for renal allograft survival. Diastolic blood pressure, LDL-cholesterol level, and exercise were the most relevant modifiable cardiovascular risk factors for the survival of renal transplant patients.
[show abstract][hide abstract] ABSTRACT: According to literature, patient and graft survival is better in living donor renal transplants (LRT) than in cadaver renal transplants (CRT). Objective: To study factors that determine the best results in LRT related to those of CRT, found in univariate studies.
Renal transplants (RT) done in Catalonia during the 1990-2004 period, performed in patients over 17 years (135 LRT and 3.831 CRT), have been analyzed (retransplants were not included). The data come from the Renal Patients Transplant Registry (RMRC). Student's t-test and chi2 test have been used for mean and for proportions comparisons, respectively. To analyze univariate and multivariate survival, actuarial method and Cox regression have been used, respectively. Estimated creatinine clearance has been studied and its data have been showed through Selwood modified Analysis.
As it happens with other great RT patients series, the RMRC analysis, globally and without any adjustment, shows that patient and graft survival in LRT is better than that obtained with CRT. When we studied which variables explain these results, we found that main factors were smaller recipient age and the short time on dialysis. The great influence of both factors has been published in a large number of papers, explaining the differences obtained on the transplanted renal patient survival.
Once adjusted the analysis by the different factors that influence the survival of the patient and the graft, there are no differences in the obtained results, since the best outcomes of the TRV are due to factors like the smaller recipient age and the advanced TR.
Nefrologia: publicacion oficial de la Sociedad Espanola Nefrologia 02/2008; 28(2):159-67. · 1.27 Impact Factor
[show abstract][hide abstract] ABSTRACT: When the field of transplantation was first developing, physicians worried about the teratogenicity of immunosuppressive medications and considered pregnancy ill-advised. The purpose of this study is to analyze pregnancy after kidney transplantation and their consequences on mother, graft and child. We review ten pregnant women with kidney transplantation, average of 29 years old and 44 months post-kidney transplantation. The mean glomerular filtration rate was 64 ml/min and the immunosuppression was with prednisone and tacrolimus. We analyze outcomes of different variables before and during pregnancy, and after labour. Pregnancy finished in nine of ten patients. Three patients needed cesarean section and only one patient had a miscarriage on the first term. Blood arterial pressure increased at the end of pregnancy and the creatinine level was stable with a few increase of proteinuria at the third term. We increased the tacrolimus dose to obtain the correct blood levels and any rejection was detected. We had only one patient with preeclampsia that we solved with a cesarean section. Labours were a mean of 37.2 weeks and the mean birth weight of infant was 2,809 grams. Two newborns had prematurity without structural malformations. Pregnancy after kidney transplantation is safe with prednisone and tacrolimus when the renal function is good, proteinuria doesn't exist and blood pressure is controlled.
Nefrologia: publicacion oficial de la Sociedad Espanola Nefrologia 02/2008; 28(2):174-7. · 1.27 Impact Factor
[show abstract][hide abstract] ABSTRACT: Prophylactic and pre-emptive therapy with oral valganciclovir for cytomegalovirus infection in renal transplant recipients. Background: Cytomegalovirus infection is a very important health problem in solid organ transplant recipients (SOT). Once-daily valganciclovir has been shown to be as clinically effective and well tolerated as oral ganciclovir tid in the prevention of CMV infection in high risk SOT recipients.
The aim of the present study was to evaluate the incidence and severity of CMV disease in 150 renal transplant recipients that received either prophylactic [high risk group (HR), N = 66] or pre-emptive [low risk group (LR), N = 84] therapy with oral valganciclovir (900 mg/day vo) for three months according to their basal risk. Patients were monitored for signs and symptoms of CMV disease and CMV plasma viral load was assessed weekly.
A total of 31 patients (47%) of the HR and 26 patients (31%) of the LR presented a positive CMV PCR result. Twelve patients (14.3%) in the LR that had a high viral load (CMV PCR > 1,000 copies/mL) but remained asymptomatic received pre-emptive therapy. Four patients (4.7%) in the LR, after an average time of 35 days after transplant and two patients (4.5%) in the HR, after prophylactic treatment was completed, developed CMV disease. The disease was mild-moderate in most of the cases. Those patients that developed CMV disease responded to treatment with iv ganciclovir for 14 days followed by treatment with oral valganciclovir for up to three months.
Prophylactic treatment with oral valganciclovir for CMV prevention is only required in high risk solid organ transplant recipients.
Nefrologia: publicacion oficial de la Sociedad Espanola Nefrologia 01/2008; 28(3):293-300. · 1.27 Impact Factor
[show abstract][hide abstract] ABSTRACT: Background: According to literature, patient and graft survival is better in living donor renal transplants (LRT) than in cadaver renal transplants (CRT). Objective: To study factors that determine the best results in LRT related to those of CRT, found in univariate studies. Patients and Methods: Renal transplants (RT) done in Catalonia during the 1990-2004 period, performed in patients over 17 years (135 LRT and 3.831 CRT), have been analyzed (retrans-plants were not included). The data come from the Renal Pa-tients Transplant Registry (RMRC). Student's t-test and χ 2 test were used to compare means and proportions, respectively. To analyze univariate and multivariate survival, actuarial method and Cox regression have been used, respectively. Estimated crea-tinine clearance has been studied and its data have been sho-wed through Selwood modified Analysis. Results: As it happens with other great RT patients series, the RMRC analysis, globally and without any adjustment, shows that patient and graft survival in LRT is better than that obtained with CRT. When we studied which variables explain these results, we found that main factors were smaller recipient age and the short time on dialysis. The great influence of both factors has been published in a large number of papers, explaining the differen-ces obtained on the transplanted renal patient survival. Conclusions: Once adjusted the analysis by the different factors that influence the survival of the patient and the graft, there are no differences in the obtained results, since the best outcomes of the TRV are due to factors like the smaller recipient age and the advanced TR. RESUMEN Introducción: Según la literatura hay una mejor supervi-vencia del paciente e injerto en los trasplantes renales (TR) realizados con órganos procedentes de donante vivo. Objetivos: Estudiar los factores que determinan los mejo-res resultados en el trasplante de donante vivo (TRV) res-pecto al de donante cadáver (TRC), hallados en estudios univariados. Pacientes y métodos: Se analizan los primeros TR realiza-dos en Cataluña en el período 1990-2004 en mayores de 17 años (135 TRV y 3.831 TRC). Los datos proceden del Regis-tro de enfermos renales de Cataluña (RMRC). Se ha utiliza-do la t-Student para la comparación de medias y el test de la χ 2 para la de proporciones. Para el análisis univariado de la supervivencia se ha utilizado el método actuarial y la re-gresión de Cox para el multivariado. Se ha estudiado la depuración estimada de la creatinina y sus datos se han representado con el análisis de Selwood modificado. Resultados: Al igual que ocurre con las grandes series de trasplantados renales, el RMRC objetiva que, globalmente y sin ningún tipo de ajuste, el TRV presenta mejores resul-tados de supervivencia de paciente e injerto que el TRC. Cuando estudiamos los factores más relevantes para expli-car estos resultados, obtenemos que los más determinan-tes son la menor edad del receptor y el menor tiempo en diálisis. Numerosas publicaciones han demostrado que ambos factores tienen una gran influencia sobre la super-vivencia del paciente trasplantado renal, condicionando la diferencia en las supervivencias obtenidas. Conclusiones: Una vez ajustado el análisis por los diferen-tes factores que intervienen en la supervivencia del pa-ciente y del injerto, no existen diferencias en los resulta-dos obtenidos por los dos tratamientos, ya que los mejores resultados del TRV son debidos a factores como la menor edad del receptor y el TR anticipado. Palabras clave: Trasplante renal de donante vivo. Supervivencia. Comparación de resultados. Registros.
[show abstract][hide abstract] ABSTRACT: Comprehensive imaging evaluation of kidney donor anatomy is crucial for selecting candidates for living kidney transplantation and for determining the surgical technique to procure the renal graft. In 76 living renal donors we compared the results of preoperative magnetic resonance angiography (MRA) with the intraoperative findings of arterial anatomy. Donors were evaluated for the number of main renal arteries and the presence of any polar arteries. A total of 80 main renal arteries and five polar arteries were observed at MRA. At surgery, 90 main renal arteries and eight polar arteries were identified. MRA demonstrated a sensitivity, specificity, and overall accuracy of 18%, 98%, and 87%, respectively, for main arteries and 25%, 96%, and 88% for polar arteries. Eleven (14.5%) kidneys displayed more than one main artery and MRA only detected two cases. Eight kidneys had polar arteries and MRA only detected two cases. MRA is a reliable method for presurgical evaluation of renal arteries in potential donors, providing valuable information required by the surgeon. But, as the technique misses small-diameter vessels, it cannot be recommended as the sole diagnostic tool in unclear cases.