Donor Kidney Volume Predicts One and Three Month eGFR in Live Donor Kidney Transplant Recipients.
1Multi-Organ Transplant Program, Toronto General Hospital, University Health Network, Toronto, ON, Canada
2Kidney Transplant Program, Toronto General Hospital, University Health Network, Toronto, ON, Canada
Meeting: 2017 American Transplant Congress
Abstract number: A241
Keywords: Graft function, Kidney transplantation, Living-related liver donors, Renal function
Session Information
Date: Saturday, April 29, 2017
Session Name: Poster Session A: Living Donor Kidney Transplant I
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
Introduction
There has been increasing interest in non-immunological factors that may impact long-term graft survival after kidney transplantation. It is hypothesized that transplantation of larger nephron mass will decrease glomerular hypertension and hyperfiltration and increase graft survival. However, the effect of kidney allograft volume on graft function in living donor kidney transplantation (LDKT) has conflicting results.
Methods
Computed Tomography (CT) volumetric donor kidney measurements were performed on live donor kidney transplantations at the Toronto General Hospital from Apr 2007 to Nov 2015. Measured kidney weight was correlated to CT volume for a smaller subset of patients. Transplantation, peri-operative care and immunosuppression were according to local standard protocols. Estimated glomerular filtration rate (eGFR) was calculated at 1- and 3-months post-transplant using the CKD-EPI formula. Multiple linear regression was used to assess the independent relationship between kidney volume and recipient kidney function at 1- and 3-months post-transplant.
Results
400 LDKT with CT volume donor kidney measurements were performed during the study period. The average volume of the donor kidney was 157.9 (SD 32.8) cc and the median weight was 183 (IQR 71) g. Donor kidney CT volume were correlated with graft weight (r= 0.59, p= <0.001). In a multiple linear regression model, donor kidney volume was independently associated with recipient eGFR at 1 and 3 months (p=0.001). For every 10 cc increase in kidney volume, eGFR increased by 1.6 mL/min and 1.1 mL/min per 1.73 m2 at 1- and 3-months, respectively. CT volume had the largest impact on predicted eGFR among all continuous variables in the model.
Conclusion
Donor kidney volume is significantly associated with recipient eGFR at 1- and 3-months. The development of a prediction model for best expected eGFR in LDKT recipients (using CT volume, weight, and other predictors) is ongoing. This index may improve the matching of living donor kidneys to potential recipients in kidney paired donation.
CITATION INFORMATION: Al-Adra D, Lambadaris M, Barbas A, Li Y, Goldaracena N, Famure O, Kim S, Ghanekar A. Donor Kidney Volume Predicts One and Three Month eGFR in Live Donor Kidney Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Al-Adra D, Lambadaris M, Barbas A, Li Y, Goldaracena N, Famure O, Kim S, Ghanekar A. Donor Kidney Volume Predicts One and Three Month eGFR in Live Donor Kidney Transplant Recipients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/donor-kidney-volume-predicts-one-and-three-month-egfr-in-live-donor-kidney-transplant-recipients/. Accessed January 25, 2021.« Back to 2017 American Transplant Congress