Impact of the ratio of graft kidney volume to recipient body surface area on graft function after live donor kidney transplantation

Objectives: Our objective was to evaluate the effect of kidney graft weight-to-recipient body weight ratio as a nonimmune factor that may affect long-term graft function. Materials and Methods:We retrospectively collected data from 2531 living donor kidney transplant procedures performed between 1994 and 2010 at Shahid Labbafinejad Medical Center; 635 patients were included in this study. Each kidney was weighed after cold wash. The kidney weight-to-recipient body weight ratio was calculated. As an indicator of graft function, we used the Modification of Diet in Renal Disease Study Group equation to estimate glomerular filtration rate. For statistical analyses, we used simple linear regression analysis and the mixed model test using SPSS version 17.0 software (SPSS, Chicago, IL, USA). Results: Mean age of recipients and median follow-up duration were 37.5 years (range, 6-77 y) and 36 months (range, 25-84 mo). Long-term graft function showed a positive correlation with kidney graft-to-recipient body weight ratio but not with the graft weight alone. The magnitude of this correlation was higher early after surgery (day 7) and decreased with long-term follow-up but was still statistically significant (P < .001). Conclusions: From our results, we conclude that kidney graft-to-recipient body weight ratio is correlated with the kidney graft function; graft size matching may be considered for kidney donor selection.

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Untitled

Simforoosh

Soltani²,

Kashi³

et al. 2017

“…Table 2 summarizes the studies reporting the risk factors associated with the incidence of DGF in living-donor kidney transplants. 11,17,31,32,33,38,41,44,46,48,52,54,58,64,65 Treating risks associated with DGF Given the paucity of data about the effects of and the risk factors for DGF in living-donor kidney transplant, studies that focus on treating these risk factors are also limited. However, given the effects of DGF after living-donor kidney transplant, strategies to minimize or prevent the risk of DGF are needed.…”

Section: Other Risk Factorsmentioning

confidence: 99%

“…28 Lee and associates also reported that graft kidney volume-to-recipient body surface area ratio is significantly associated with graft function. 41,42 Although obesity in itself may independently affect DGF, it has been suggested that this should not be seen as a disqualification for patients and that graft function can also be ensured by focusing on the relative capacity of the renal graft in relation to the recipient. 37 Preoperative renal function is also an important factor in determining graft function.…”

Section: Body Mass Indexmentioning

confidence: 99%

Untitled

2016

With an increased incidence of living-donor kidney transplants, in response to increasing unmet needs for renal transplant, a clear understanding of determinants of posttransplant outcomes is essential. The importance of delayed graft function in deceased-donor kidney transplant is now part of conventional medical wisdom, due to the large amount of evidence focused on this aspect. However, the same is not true for living-donor kidney transplant, partly due to lack of evidence on this crucial clinical question and partly due to lack of awareness about this issue. The current review aims to highlight the importance of delayed graft function as a crucial determinant of outcomes in living-donor kidney transplant. An exhaustive search of online medical databases was performed with appropriate search criteria to collect evidence about delayed graft function after living-donor kidney transplant, with a special focus on studies from the Middle East. Data on incidence, impact, risk factors, and possible prevention modalities of delayed graft function in patients undergoing living-donor kidney transplant are presented. A key finding of this review is that contemporary incidence rates reported from the Middle East are comparatively higher than those reported from outside the region. Although in absolute terms the incidence is lower than deceaseddonor kidney transplant, the effects of delayed graft function on graft rejection and graft and patient survival are sufficiently large to warrant the formulation of specific treatment protocols. Key to formulating prevention and treatment strategies is identifying discrete risk factors for delayed graft function. Although this evidence is scant, an overview has been provided. Further studies examining different aspects of delayed graft function incidence after living-donor kidney transplant are urgently needed to address a so far little known clinical question.

“…4 These risk factors include donor age, sex, body mass index, kidney size, race difference, and sex disparity. [5][6][7][8][9] However, few studies have longitudinally correlated graft function with descriptive models of donor and recipient characteristics in the Chinese population.…”

Section: Introductionmentioning

confidence: 99%

Untitled

Suri²,

Huang³

et al. 2014

Objectives: The purpose of this study was to evaluate the effect of donor-recipient body surface area ratio on donor age and donor glomerular filtration rate in living-donor kidney transplant. Materials and Methods: This retrospective study included 254 rejection-free patients who underwent their first living-donor kidney transplant at our center between April 2007 and April 2011. We performed multivariate linear regression and receiver operating characteristic curve analyses to determine independent associations and the cumulative effects on posttransplant graft function and outcomes in persons in China who had a livingdonor kidney transplant. Results: In multivariate linear regression, donor age, donor estimated glomerular filtration rate, and donor-recipient body surface area ratio were independent predictors of 1-year graft function. Linear regression showed that correcting donor age by donor-recipient body surface area ratio increased the strength of the correlation between donor age and 1-year graft function. In the older group (donor age ≥ 45 y), the effect of donor-recipient body surface area ratio on graft function was stronger. By considering the 1-year donor estimated glomerular filtration rate in 2 groups (< 60 or ≥ 60 mL/min/1.73 m 2 ), the cutoff values for corrected donor age was 55 years and donor estimated glomerular filtration rate before surgery was 113 mL/min/1.73 m 2 . Conclusions: By correcting for donor-recipient body surface area ratio, donor age accurately predicted and correlated better with 1 year graft function. During preoperative evaluation donor and recipient body surface area matching may be useful.