During living donor and recipient matching, both the potential sizes of the donated kidney and the recipient should be considered in terms of the early graft function after transplantation.
Kidney donation from female donors to male recipients has been reported to be associated with decreased allograft survival. Whether there was a gender-related inadequacy between donor nephron supply and recipient functional demand was investigated in this study. One hundred ninety-five living donor kidney transplant recipients that had neither ischemic injury, episode of rejection, nor any complication were included. Weights and heights of both donors and recipients were recorded to calculate body surface area, lean body weight, and body mass index. The donated kidney was weighed just after cold flush, and the recipient's serum creatinine (Scr) was measured on a daily basis postoperatively. When the recipient's Scr reached the baseline, a 24-h urine was collected for the amount of proteinuria (Upr), creatinine excretion (Ucr) and creatinine clearance (Ccr) calculation. The effect of donor and recipient gender was analysed by independent sample t-test. On average, male donors and recipients were heavier and taller than females. However, the mass of kidneys donated from men and women were not statistically different. The gender-related differences in post-transplant Scr and Ucr of recipients were associated with the differences in the parameters of metabolic demands of recipients rather than with the weight of implanted kidney (renal mass supply) or with pre-operative renal functions of donors (functional supply). The early graft function is not determined by donor gender. The effect of recipient gender on the graft function depends on the metabolic demands, which are higher in male recipients.
Summary The incidence of malignancy in transplant recipients is known to be higher than the same in the general population. However, the types of malignancies vary geographically, and the relative risks (RR) for malignancy in transplant recipients, compared with that of the general population, also differ country‐by‐country. In this study, we investigated the incidence and characteristics of malignancies after renal transplantation in a single center. A total of 2630 renal recipients who underwent surgery between April 1979 and June 2007 were enrolled in this study. The cumulative and interval incidences of malignancies were calculated for every 3 years post‐transplantation. One‐hundred ninety cases of postrenal transplant malignancies among 177 recipients (6.73%) were reported until 2007. The post‐transplant malignancies were detected from 6 to 290 months after transplantation, with a mean duration of 112.6 ± 66.0 months. Skin cancer [35 (18.4%)] was the most common post‐transplant malignancy, followed by thyroid [25 (13.2%)], stomach [22 (11.6%)], colorectal [22 (11.6%)], and urologic cancers [19 (10.0%)]. As the post‐transplant period increased, the interval incidence of malignancy correspondingly increased. Virus‐related malignancies, such as Kaposi’s sarcoma and cervical cancer, developed earlier within the post‐transplant period, while urologic cancer, colorectal cancer developed late in the post‐transplant period. The recipient’s age at the time of transplantation was the sole independent risk factor for post‐transplant malignancy based on the multivariate analysis (RR = 2.723, P < 0.0001 in the >50‐year‐old age group). We should establish strategies for post‐transplant malignancy‐screening based on the recipient’s age at the time of transplantation, the post‐transplant interval, and the national trend of post‐transplant malignancy.
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