Date: Tuesday, June 14, 2016
Session Name: Concurrent Session: Living Kidney Donor Evaluation
Session Time: 4:30pm-6:00pm
Presentation Time: 5:42pm-5:54pm
Location: Ballroom B
Kidney structural characteristics may be predictive of long-term living donor outcomes such as a lower estimated Glomerular Filtration Rate (eGFR).
As part of the Renal and Lung Living Donors Evaluation (RELIVE) Study, kidney donors with implantation biopsies and pre-donation CT scans were studied for long-term outcomes at least 5 years after donation by a serum creatinine based eGFR with the CKD-EPI equation. There were 868 living donors during the time period 2000-2005, of which, 391 (45%) participated with a follow-up serum creatinine. Of these 391 donors, 334 had macro-structural measures of the retained kidney at baseline by pre-donation CT scan (cortical volume and surface roughness) and 268 had micro-structural measures of the implantation biopsy of the donated kidney by morphometry, stereology, and pathologist review. Nephron number was estimated from cortical volume [times] glomerular density.
On CT, the mean cortical volume was 105 cc and kidney surface roughness was 0.9 (range 0 to 3). On biopsy, the mean glomerular density was 14 per mm3, glomerular volume was 0.0028 mm3, % intimal occlusion was 32%, and nephron number was 813,382; any interstitial fibrosis and tubular atrophy occurred in 24% and any glomerulosclerosis in 35%. At follow-up, a mean 7.9 years after donation (mean age of 54 years), the mean eGFR was 67 (31% were 45-59 and 3.5% were <45 ml/min/1.73 m2. Association of kidney structural findings at donation with follow-up eGFR is shown in the Table.
Cortical volume of the retained kidney may have utility for predicting long term kidney function in donors.
|Clinical and structural predictors of long-term eGFR in donors|
(per SD if continuous)
|Beta||P value||Beta||P value|
|Cortex surface roughness||-1.8||0.04||-0.5||0.53|
|% Interstitiall fibrosis||-3.2||0.002||-1.1||0.22|
|# of tubular atrophy foci||-3.5||0.003||-0.7||0.49|
|% intimal occlusion||-2.7||0.005||-1.0||0.25|
CITATION INFORMATION: Mathew J, Denic A, Alexander M, Vrtiska T, Chakkera H, Taler S, Rule A. Kidney Structural Characteristics as Predictors of Long-Term Kidney Function in Living Kidney Donors. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Mathew J, Denic A, Alexander M, Vrtiska T, Chakkera H, Taler S, Rule A. Kidney Structural Characteristics as Predictors of Long-Term Kidney Function in Living Kidney Donors. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/kidney-structural-characteristics-as-predictors-of-long-term-kidney-function-in-living-kidney-donors/. Accessed March 6, 2021.
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