J Korean Soc Transplant.  2015 Dec;29(4):209-215. 10.4285/jkstn.2015.29.4.209.

Impact of Graft Kidney Volume and Weight on Graft Function in Living Donor Kidney Transplantation

Affiliations
  • 1Department of Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea. dltngudgs@aumc.ac.kr
  • 2Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.

Abstract

BACKGROUND
Low functional nephron mass and graft kidney-recipient body size mismatch can lead to poor graft function. To examine the impact of the ratios of the surrogates to recipient body surface area (BSA) and body weight on graft function within 5 years post-transplantation, we measured the graft kidney volume, using computed tomography with 3-dimensional reconstruction before transplantation, and measured the graft kidney weight during surgery in living donor kidney transplantation (LDKT).
METHODS
Between February 2004 and November 2013, 142 LDKT recipients without delayed graft function, acute rejection, or infection within 5 years of transplantation were included. The graft function and its relations with graft kidney volume and its weight were analyzed.
RESULTS
The graft kidney volume/recipient BSA ratio showed correlation with the estimated glomerular filtration rate (eGFR) of recipients after 3 years post-transplantation. We found a difference in the graft function between recipients with a graft kidney volume/recipient BSA ratio of > or =80.4 mL/m2 and those with a ratio of <80.4 mL/m2 (P<0.05). Multivariate analysis showed that the graft kidney volume/recipient BSA ratio, the graft kidney weight/recipient body weight ratio, donor age, donor eGFR, and donor/recipient BSA ratio are independent predictors of graft function at each period of transplantation (P<0.05).
CONCLUSIONS
The graft kidney volume of living donors may predict graft function and during living donor and recipient matching, both the potential volume of the donated kidney and the body size of the recipient should be considered.

Keyword

Kidney transplantation; Graft volume; Graft weight; Graft function

MeSH Terms

Body Size
Body Surface Area
Body Weight
Delayed Graft Function
Glomerular Filtration Rate
Humans
Kidney Transplantation*
Kidney*
Living Donors*
Multivariate Analysis
Nephrons
Tissue Donors
Transplants*

Cited by  1 articles

Clinical outcomes of the first 300 cases of kidney transplantation: a single-center retrospective cohort study
Hyoung Won Koh, Kyunglim Koo, Chang Sik Shin, Hyung Sub Park, Jong Cheol Jeong, Sejoong Kim, Dong Wan Chae, Jong Jin Oh, Seok-Soo Byun, Taeseung Lee
Korean J Transplant. 2020;34(3):154-166.    doi: 10.1371/journal.pone.0208638.


Reference

References

1). Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999; 341:1725–30.
Article
2). Hariharan S, Johnson CP, Bresnahan BA, Taranto SE, McIntosh MJ, Stablein D. Improved graft survival after renal transplantation in the United States, 1988 to 1996. N Engl J Med. 2000; 342:605–12.
Article
3). Heemann UW, Azuma H, Tullius SG, Mackenzie H, Brenner BM, Tilney NL. The contribution of reduced functioning mass to chronic kidney allograft dysfunction in rats. Transplantation. 1994; 58:1317–22.
4). Kim YS, Moon JI, Kim DK, Kim SI, Park K. Ratio of donor kidney weight to recipient bodyweight as an index of graft function. Lancet. 2001; 357:1180–1.
Article
5). Poggio ED, Hila S, Stephany B, Fatica R, Krishnamurthi V, del Bosque C, et al. Donor kidney volume and outcomes following live donor kidney transplantation. Am J Transplant. 2006; 6:616–24.
Article
6). Giral M, Foucher Y, Karam G, Labrune Y, Kessler M, Hurault de Ligny B, et al. Kidney and recipient weight incompatibility reduces longterm graft survival. J Am Soc Nephrol. 2010; 21:1022–9.
Article
7). el-Diasty TA, Shokeir AA, el-Ghar ME, Gad HM, Refaie AF, el-Din AB. Contrast enhanced spiral computerized tomography in live kidney donors: a single session for anatomical and functional assessment. J Urol. 2004; 171:31–4.
Article
8). Janoff DM, Davol P, Hazzard J, Lemmers MJ, Paduch DA, Barry JM. Computerized tomography with 3-dimensional reconstruction for the evaluation of renal size and arterial anatomy in the living kidney donor. J Urol. 2004; 171:27–30.
Article
9). Sommer G, Bouley D, Frisoli J, Pierce L, Sandner-Porkristl D, Fahrig R. Determination of 3-dimensional zonal renal volumes using contrast-enhanced computed tomography. J Comput Assist Tomogr. 2007; 31:209–13.
Article
10). Du Bois D, Du Bois EF. A formula to estimate the approximate surface area if height and weight be known 1916. Nutrition. 1989; 5:303–11.
11). Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, et al. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006; 145:247–54.
Article
12). Almond PS, Matas A, Gillingham K, Dunn DL, Payne WD, Gores P, et al. Risk factors for chronic rejection in renal allograft recipients. Transplantation. 1993; 55:752–6.
13). Brenner BM, Cohen RA, Milford EL. In renal transplantation, one size may not fit all. J Am Soc Nephrol. 1992; 3:162–9.
Article
14). Terasaki PI, Koyama H, Cecka JM, Gjertson DW. The hyper-filtration hypothesis in human renal transplantation. Transplantation. 1994; 57:1450–4.
Article
15). Akoglu H, Yildirim T, Eldem G, Arik G, Yilmaz R, Kutlugun AA, et al. Living donor kidney volume as a predictor of graft function: is there a role for proteinuria? Transplant Proc. 2013; 45:77–81.
Article
16). Lee JH, Won JH, Oh CK. Impact of the ratio of graft kidney volume to recipient body surface area on graft function after live donor kidney transplantation. Clin Transplant. 2011; 25:E647–55.
Article
17). Huh KH, Yun M, Kim TS, Cho A, Lee JD, Myoung SM, et al. Measurement of donor kidney functional renal volume and glomerular filtration rate to predict allograft function during the posttransplantation period. Nephron Clin Pract. 2009; 113:c262–9.
Article
18). Hugen CM, Polcari AJ, Farooq AV, Fitzgerald MP, Holt DR, Milner JE. Size does matter: donor renal volume predicts recipient function following live donor renal transplantation. J Urol. 2011; 185:605–9.
Article
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