Mayo Adhesive Probability (MAP) score of non-donated kidney aids in predicting post-operative renal function following donor nephrectomy

Abstract

Background: To examine the association of preoperative Mayo Adhesive Probability (MAP) scores in the donor (MAP d) and non-donor kidneys (MAP nd) with post-donation renal function. Methods: Three hundred thirty-one patients undergoing hand assisted laparoscopic donor nephrectomy (HALDN) were reviewed. MAP d and MAP nd were obtained. Estimated glomerular filtration rate (eGFR) was recorded preoperatively and at 1 day, 1 month, and 6 months postoperatively. Results: Two hundred females and 131 males were evaluated with median BMI 26.4 kg/m 2 (range 17.1-39.6) and median age 45 years (range 19-78). MAP d score was 0 for 231 patients (69.8%) and > 0 for 100 patients (30.2%). MAP nd score was 0 for 234 patients (70.7%) and > 0 for 97 patients (29.3%). The median preoperative eGFR was 86.6 ml/min/ 1.73m 2 (range 48.8-138.4). After adjusting for preoperative eGFR, BMI, ASA score, and kidney sidedness, postoperative eGFR was associated with MAP score in the non-donated kidney (p = 0.014) but not in the donated kidney (p = 0.24). Compared to donors with MAP nd = 0, donors with a MAP nd > 0, mean eGFR was − 2.33 ml/min/1.73m 2 lower at postoperative day 1 (95% CI − 4.24 to − 0.41, p = 0.018), − 3.02 ml/min/1.73m 2 lower at 1 month (95% CI − 5.11 to − 0.93, p = 0.005), and − 2.63 ml/min/1.73m 2 lower at 6 months postoperatively (95% CI − 5.01 to − 0.26, p = 0.030). Conclusions: MAP score > 0 in the non-donated kidney is associated with worse renal function in the 6 months following HALDN.

Impact of the Mayo Adhesive Probability Score on Donor and Recipient Outcomes After Living-donor Kidney Transplantation: A Retrospective, Single-center Study of 782 Transplants

“…This result appears to support our hypothesis that the presence of APF and a high MAP score might influence LDKT recipient outcomes, based on a previous study in which the presence of APF and a high MAP score influenced kidney function in LDKT recipients with type 2 diabetes. 5 , 6 However, eGFR reductions within 5 y after LDKT were similar in both groups. In addition, the recipient mortality and incidence of acute rejection within 1 y after LDKT did not significantly differ between the 2 groups.…”

“…Notably, several previous reports concerning the relationships of the MAP score with donor nephrectomy outcomes have categorized the MAP score as 0 or >0 because of the small numbers of donors with a MAP score of 1 to 5, which influences the statistical strength. 4 , 6 Therefore, we divided all transplants into 2 groups: those with donor MAP score of 0 (ie, MAP 0 group) and those with donor MAP score of 1–5 (ie, MAP 1–5 group). The numbers of patients in the MAP 0 and MAP 1–5 groups were 451 and 331, respectively.…”

“…Cockerill et al 6 reported that the nondonated kidney MAP score influenced postoperative donor eGFR, and Holscher et al 18 reported that postoperative donor kidney function can predict graft survival after LDKT. Therefore, we investigated the relationship between donor MAP score and graft survival, but we found no difference in graft survival rate between the 2 groups in this study.…”

“…Lamacchia et al 5 reported that a greater thickness of perinephric fat was associated with lower eGFR in patients with type 2 diabetes. Cockerill et al 6 also reported that a MAP score ≥1 in the nondonated kidney was associated with lower donor eGFR after nephrectomy. Thus, we hypothesized that the donor APF and a high MAP score might contribute to poor outcomes in LDKT recipients.…”