Impact of donor/recipient gender, age, HLA matching, and weight on short-term graft survival following living related renal transplantation

Shaheen, F. A. M.; Sulaiman, M. A.; Mousa, Dujanah; Din, A.B.S El; Hawas, Fahad; Fallatah, Abdullah; Bill, P. L. A.; Sheikh, Iftikhar Ahmed; Menawy, L Al; Ramprasad, K. S.; Al-Khader, Abdullah A

doi:10.1016/s0041-1345(98)01179-8

Cited by 8 publications

(10 citation statements)

References 16 publications

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“…A similar observation was reported by Nishimura et al [12]who found the donor kidney weight/recipient body weight ratio in adult living-donor kidney transplant patients a significant predictor of graft survival. In contrast to our results, Shaheen et al [14]did not find any impact of donor weight on cumulative graft survival in living-donor transplants. One reason for this difference in results could by explained by differences in sample size and the other reasons may be related to the study design or the duration of follow-up.…”

Section: Discussioncontrasting

confidence: 99%

“…However, as in any retrospective analysis, a statistical association does not prove causality, and the mechanisms that may explain the association cannot be determined from these results. Previous studies investigating the effect of donor/recipient size have produced conflicting results both in living-donor [9, 12, 14, 18]and cadaveric-donor transplantations [8, 10, 11, 13, 19, 20]. Kasiske et al [10]could not demonstrate the effect of donor/recipient size mismatch on short-term (4 months) outcome after kidney transplantation; however, the risk of graft failure was increased by 43% for large recipients from small donors, which was statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, chronic hyperfiltration together with reduced functioning kidney mass might damage the graft, initiating a vicious circle of a further reduction in renal mass which in turn causes more significant hyperfiltration leading to a progressive decline in the glomerular filtration rate, proteinuria, hypertension and eventually chronic graft failure. Several small studies have suggested a correlation between the estimated nephron mass and transplant outcome [7, 8, 9, 10, 11, 12], however, not all agree with this suggestion [12, 13]on the long-term or even short-term outcome [14, 15]. Most of these studies were on cadaveric donors and include a small number of patients.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Donor/Recipient Body Weight Mismatch on Patient and Graft Outcome in Living-Donor Kidney Transplantation

et al. 2003

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Background/Aims: There have been conflicting reports showing that kidneys from small donors may be at risk for graft loss if they are transplanted into large recipients. The aim of this work was to examine the donor/recipient body weight ratio (D/RBWR) on patient and graft outcome. Methods: During the period from January 1990 to January 2002, 856 kidney transplants were performed. Of these, 776 kidney transplant recipients were selected after exclusion of pediatric, second transplant patients and those with a body mass index of ≧35. All patients achieved a minimum follow-up of 1-year. According to D/RBWR, patients were divided into 3 groups: low (≤0.9), medium (0.91–1.2) and high (≧1.2). Data were collected on graft function, acute and chronic rejection, post-transplant complications, and 1- and 5-year graft and patient survival. Results: There was a statistically significant increase in the incidence of chronic rejection, post-transplant hypertension and diabetes mellitus in the low group. The incidence and frequency of acute rejection episodes were nearly the same in the 3 groups. Graft function, estimated by serum creatinine at 1 year, was significantly lower in the low group. The 5-year graft and patient survival was 71, 80, 88 and 81, 85 and 92%, in the low, medium and high groups, respectively. Conclusions: We conclude that a low D/RBWR may contribute to inferior long-term renal allograft survival. The hyperfiltration hypothesis due to low nephron mass in the low D/RBWR group may explain these findings.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of Donor/Recipient Body Weight Mismatch on Patient and Graft Outcome in Living-Donor Kidney Transplantation

et al. 2003

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“…We conducted a MED-LINE search for studies that have investigated the effects of donor-recipient size mismatching on kidney graft survival (Table 2). We identified 11 published studies, but 6 had not yet been published in a peer-reviewed journal, and many details of the analysis in these 6 studies were missing (10,13,16,20,33,34). There were 8 single-center studies, (10 -17) and it is likely that many of these single-center studies lacked adequate statistical power to test the hypothesis.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, none of the 4 studies reporting a statistically significant effect of donor-recipient size disparity on graft survival performed a multivariate analysis (10,11,13,20). In addition, 7 studies used recipient body weight rather than BSA as a measure of recipient size (10,13,(15)(16)(17)33,34). Most studies failed to distinguish the effects of donor-recipient size mismatches on early versus late graft failure.…”

Section: Discussionmentioning

confidence: 99%

Inadequate Donor Size in Cadaver Kidney Transplantation

Kasiske¹,

Snyder²,

Gilbertson³

2002

Journal of the American Society of Nephrology

118

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Abstract. There have been conflicting reports that kidneys from small donors may be at increased risk for late graft failure if they are transplanted into large recipients. Data from the United States Renal Data System was used to study all first cadaver kidney transplantations performed during the years 1994 to 1999. Donor and recipient body surface area (BSA) combinations were included along with other patient and transplant characteristics in a Poisson analysis of factors associated with early (in the first 4 mo) and late (Ն4 mo) graft failure. The numbers of large (BSA Ͼ2.2 m 2 ) and medium size (BSA 1.6 to 2.2 m 2 ) recipients that received kidneys from small (BSA Ͻ1.6 m 2 ) donors are less than expected ( 2 ϭ 118.09; P Ͻ 0.0001), suggesting that transplant centers may be refusing some kidneys on the basis of donor-recipient size differences. Large recipients who received kidneys from small donors made up 1.5% of the population and had a 43% (95% CI, 17 to 75%; P ϭ 0.0004) increased risk of late graft failure compared with medium-size recipients who received kidneys from mediumsize donors (53.4% of the population). Medium-size recipients who received kidneys from small donors made up 12.0% of the population and had a 16% (95% CI, 6 to 26%; P ϭ 0.0012) increased risk of late graft failure. Disparities in recipient and donor size had similar adverse affects on mortality. Effects of recipient obesity (body mass index) and donor gender on late graft survival were no longer statistically significant after the effects of donor and recipient body size were taken into account. In conclusion, the relative size of the donor and recipient should possibly be taken into account when choosing kidneys for transplantation.

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