David P Al-Adra1,2,3, Maria Lambadaris1, Andrew Barbas1,2,3, Yanhong Li1, Markus Selzner1,2,3, Sunita K Singh1,4,5, Olusegun Famure1, S Joseph Kim1,4,5, Anand Ghanekar6,7,8,9. 1. Kidney Transplant Program, Toronto General Hospital, University Health Network, Toronto, Canada. 2. Division of General Surgery, University Health Network, Toronto, Canada. 3. Department of Surgery, University of Toronto, Toronto, Canada. 4. Division of Nephrology, University Health Network, Toronto, Canada. 5. Department of Medicine, University of Toronto, Toronto, Canada. 6. Kidney Transplant Program, Toronto General Hospital, University Health Network, Toronto, Canada. Anand.Ghanekar@uhn.ca. 7. Division of General Surgery, University Health Network, Toronto, Canada. Anand.Ghanekar@uhn.ca. 8. Department of Surgery, University of Toronto, Toronto, Canada. Anand.Ghanekar@uhn.ca. 9. Toronto General Hospital, 11 PMB 171, 585 University Avenue, Toronto, ON, M5G 2N2, Canada. Anand.Ghanekar@uhn.ca.
Abstract
PURPOSE: The effect of living donor kidney allograft size on recipient outcomes is not well understood. In this study, we sought to investigate the relationship between preoperatively measured donor kidney volume and recipient estimated glomerular filtration rate (eGFR) in living donor kidney transplantation (LDKT). METHODS: We studied computed tomography (CT) donor kidney volumes and recipient outcomes for 438 LDKTs at the Toronto General Hospital between 2007 and 2016. Estimated glomerular filtration rate (eGFR) was calculated at 1, 3, and 6 months and a multivariable linear regression model was fitted to study the effect of donor kidney volume on recipient eGFR. RESULTS: The mean volume and weight of the donated kidneys were 157.3 (± 32.3) cc and 186.7 (± 48.7) g, respectively. Kidney volume was significantly associated with eGFR on multivariable analysis (P < 0.001). Specifically, for every 10 cc increase in kidney volume, there was a 1.68 mL/min, 1.25 mL/min and 0.97 mL/min rise in recipient eGFR at 1, 3, and 6 months, respectively. CONCLUSIONS: Donor kidney volume is a strong independent predictor of recipient eGFR in LDKT, and therefore, may be a valuable addition to predictive models of eGFR after transplant. Further research may determine if the inclusion of donor kidney volume in matching algorithms can improve recipient outcomes.
PURPOSE: The effect of living donor kidney allograft size on recipient outcomes is not well understood. In this study, we sought to investigate the relationship between preoperatively measured donor kidney volume and recipient estimated glomerular filtration rate (eGFR) in living donor kidney transplantation (LDKT). METHODS: We studied computed tomography (CT) donor kidney volumes and recipient outcomes for 438 LDKTs at the Toronto General Hospital between 2007 and 2016. Estimated glomerular filtration rate (eGFR) was calculated at 1, 3, and 6 months and a multivariable linear regression model was fitted to study the effect of donor kidney volume on recipient eGFR. RESULTS: The mean volume and weight of the donated kidneys were 157.3 (± 32.3) cc and 186.7 (± 48.7) g, respectively. Kidney volume was significantly associated with eGFR on multivariable analysis (P < 0.001). Specifically, for every 10 cc increase in kidney volume, there was a 1.68 mL/min, 1.25 mL/min and 0.97 mL/min rise in recipient eGFR at 1, 3, and 6 months, respectively. CONCLUSIONS:Donor kidney volume is a strong independent predictor of recipient eGFR in LDKT, and therefore, may be a valuable addition to predictive models of eGFR after transplant. Further research may determine if the inclusion of donor kidney volume in matching algorithms can improve recipient outcomes.
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