Ionizing radiation exposure among kidney transplant recipients due to medical imaging during the pretransplant evaluation

Clin J Am Soc Nephrol. 2013 May;8(5):833-9. doi: 10.2215/CJN.03990412. Epub 2013 Feb 7.

Abstract

Background and objectives: Kidney transplant recipients are at increased risk for malignancies. One recognized risk for malignancy is ionizing radiation. The purpose of this study was to determine, among kidney transplant recipients, the medical imaging procedures that contribute to radiation exposure and their cumulative radiation exposure, as a result of their pretransplant evaluation.

Design, setting, participants, & measurements: Medical records of patients who received a first, kidney-alone transplant during 2008 at a single transplant center were examined. This study identified medical imaging procedures that were performed as prerequisites for deceased donor wait-listing or receipt of live donor kidney transplants and to maintain active status on the wait list. Frequencies of medical imaging procedures and cumulative effective doses of radiation were calculated.

Results: Among the 172 kidney transplant recipients, 905 procedures were performed. Seventy patients (40.7%) were exposed to low dose (0-20 mSv), 51 (29.7%) were exposed to moderate dose (>20-50 mSv), 28 (16.3%) were exposed to high dose (>50-100 mSv), and 23 (13.4%) were exposed to very high dose (>100 mSv) cumulative effective radiation. Nuclear stress tests accounted for 82.9% of the total radiation exposure. In multivariate analysis, older age, diabetes, and black race were associated with exposure to >20 mSv radiation during the pretransplant evaluation.

Conclusions: Kidney transplant recipients are exposed to large amounts of ionizing radiation from medical imaging during the pretransplant evaluation. The effects of radiation upon malignancy risk and strategies to reduce this radiation exposure warrant further investigation.

MeSH terms

  • Adolescent
  • Adult
  • African Americans
  • Age Factors
  • Chi-Square Distribution
  • Diabetes Mellitus / ethnology
  • Diagnostic Imaging* / methods
  • Female
  • Fluoroscopy
  • Humans
  • Kidney Transplantation*
  • Living Donors
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • New Jersey
  • Odds Ratio
  • Preoperative Care
  • Radiation Dosage*
  • Retrospective Studies
  • Risk Factors
  • Tomography, Emission-Computed
  • Tomography, X-Ray Computed
  • Waiting Lists
  • Young Adult