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Risk Factors and 2 Year Outcomes of Low Estimated Glomerular Filtration Rate in the Immediate Post-Operative Period for Living Kidney Donors.

H. Pahari,1 S. Nagai,1 K. Takahashi,1 F. Tinney,2 J. Denny,1 L. Malinzak,1 M. Rizzari,1 K. Collins,1 A. Yoshida,1 M. Abouljoud,1 D. Kim.1

1Henry Ford Hospital, Detroit
2Wayne State University, Detroit

Meeting: 2017 American Transplant Congress

Abstract number: A253

Keywords: Donation, Kidney, 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

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Background: While long-term risk of end-stage renal disease in living kidney donors is considered less than 0.25% at 15 years, an association between the immediate post-operative estimated GFR and long-term outcomes after donor nephrectomy remains to be elucidated.

Methods: From April 2008 to June 2014, 186 consecutive living kidney donors were retrospectively evaluated. eGFR was calculated using MDRD-4 formula. Statistical analysis was done using logistic regression analysis.

Results: The median eGFR on post-operative day 1 (eGFR1) was 51.8mL/min/1.73m2. Risk factors for eGFR1<50mL/min/1.73m2 were age>50years (OR 5.31; p=0.0004) and pre-operative eGFR <100mL/min/1.73m2 (OR 9.96; p<0.0001). Protective factors for loss in eGFR<40% post donation were female sex (p=0.001) and lower pre-operative creatinine (p<0.0001).

Risk factor for eGFR1<50 (n=186) N; % or

Mean ± SD

OR

(Univ)

p-value OR

(Multiv)

p-value
Age>50y 45; 24% 5.31 0.0002 4.74 0.0004
Sex (Female) 115; 62% 3.21 0.061 1.28 0.524
Race (non-AA) 151; 81% 3.33 0.039 1.98 0.178
BMI (kg/m2) 27.6 ± 4.8 1.05 0.227
Pre-op Creat (mg/dl) 0.8 ± 0.2 1.35 0.111
Pre-op eGFR<100 83; 45% 4.71 0.009 9.96 <0.00001
Multiple arteries 42; 23% 0.39 0.052 0.40 0.052
Operative time (min) 251 ± 48 1.00 0.310
Estimated Blood Loss (ml) 79 ± 66 1.00 0.456

Correlation between post-op creatinine and creatinine at 2 years (n=114) was strongly positive (r=0.692; p<0.0001). Older age (p=0.002) was the only independent risk factor for higher loss of renal function at 2 years (LRF2y>50%). Median recovery of eGFR at 2 years (RRF2y) was 17% of the pre-eGFR. Higher age was an independent risk factor for RRF2y<15% (p=0.001) after multivariate analysis.

Conclusions: Older donors (>50y) may have higher risk for renal dysfunction after nephrectomy and poorer long-term recovery, compared to younger donors. Older donors with pre-donation eGFR less than 100mL/min/1.73m2 should be used with caution.

CITATION INFORMATION: Pahari H, Nagai S, Takahashi K, Tinney F, Denny J, Malinzak L, Rizzari M, Collins K, Yoshida A, Abouljoud M, Kim D. Risk Factors and 2 Year Outcomes of Low Estimated Glomerular Filtration Rate in the Immediate Post-Operative Period for Living Kidney Donors. Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Pahari H, Nagai S, Takahashi K, Tinney F, Denny J, Malinzak L, Rizzari M, Collins K, Yoshida A, Abouljoud M, Kim D. Risk Factors and 2 Year Outcomes of Low Estimated Glomerular Filtration Rate in the Immediate Post-Operative Period for Living Kidney Donors. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/risk-factors-and-2-year-outcomes-of-low-estimated-glomerular-filtration-rate-in-the-immediate-post-operative-period-for-living-kidney-donors/. Accessed January 21, 2021.

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