Introduction: There is a wide gap between number of patients seeking renal transplants and potential kidney donors. Living kidney donation seems a reasonable source to bridge that gap. Few case reports demonstrated the the effect of uretro-pelvic junction dysfunction on kidney recipients. The aim of the study is to assess the effect of receiving a kidney with pyelo-ureteric junction dysfunction and other MAG3 abnormalities on renal graft function.

Methodology: Renal graft function of 198 patients who received a living kidney transplant from 1^st January 2003 to 31^st December 2013 in a single Centre in the North West of England were retrospectively reviewed using a computerised database. Split kidney function for the donors were assessed using Tcc-99mMAG3 renogram before donation. The graft function was assessed by serum creatinine and eGFR post transplantation. Each recipient of a kidney with uretro-pelvic junction dysfunction and other MAG3 abnormalities was matched with a control recipient by age, gender, and number of years since the transplant. Both groups were followed up for an average of 3.5 years post-transplant.

Results: Of the 198 kidney recipients included in the study, 22 recipients received kidneys from donors with anatomical abnormalities that appeared on the MAG3 renogram that did not preclude donation. 19 recipient had received a kidney from a donor with PUJ dysfunction. Prevalence of PUJ dysfunction was 9.5% in the all group that was studied, and it was more common in kidney received from male donors. There was no difference between the case group (n=19,m=11,f=8) and the control group (n=19,m=11,f=8) in terms of age , gender and follow up time post-transplantation. In the case group, mean serum creatinine was 103 [micro]mol/L and mean e-GFR was 48.6 ml/min while in the control group, mean creatinine was 183 [micro]mol/L and mean e-GFR was 47.5 ml/min. There was no statistical difference between the 2 groups in creatinine levels(P=0.305) or eGFR (P=0.054).

Conclusion: This small study showed that PUJ dysfunction in kidneys received from living donors has a negligible effect on the graft function of the recipients over 3.5 years period post-transplantation. In the presence of widened gap between demand and supply in renal transplantation, living kidney donors with PUJ dysfunction should be still considered for transplantation.

CITATION INFORMATION: Gledhill-Flynn C, Ali H, Ahmed A. The Outcome of Kidney Grafts from Living Donors with Pyelo-Ureteric Junction Dysfunction. Am J Transplant. 2017;17 (suppl 3).

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