*Purpose: MAP (Mayo adhesive probability) score have been known as a predictor of adherent perinephric fat (APF) in partial nephrectomy. This study is aimed to evaluate ROI(region of interest)max score as a novel predictor of APF by analyzing a cohort of Japanese healthy donor underwent laparoscopic donor nephrectomy (LDN) for renal transplantation.

*Methods: A total of 90 healthy Japanese patients underwent LDN were evaluated in this study. The presence of APF was determined by recognition of adhesions between the renal capsule and perinephric adipose tissue from the intraoperative findings. Patients backgrounds: age, gender, body mass index, smoking and visceral fat volume, ROImax score obtained from preoperative CT imaging were evaluated according to the presence of APF. ROImax was defined as maximum HU in the area. The predictors of APF were examined using logistic regression analyses.

*Results: APF was observed in 25 (28%) patients. We observed APF in 5.5% of patients with ROImax score 0, 23.1% with a score 1, 35.7% with score 2, 76.9% with a score 3. In univariate analysis, male gender, smoking history, visceral fat volume and higher ROImax score showed significant differences between APF and no APF. In multivariate analysis, only higher ROImax score was the independent predictors of APF (p=0.039).

*Conclusions: ROImax score can accurately predict the presence of APF in patients undergoing donor nephrectomy.

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