Korean J Urol.  2012 Feb;53(2):126-130.

Influence of Donor's Renal Function on the Outcome of Living Kidney Transplantation: 10-Year Follow-up

• Jeong HC
• Lee SH
• Yang DY
• Kim SY
• Kim H
• Lee SU
• Kim JW
• Lee WK

Abstract

PURPOSE
With the improved surgical techniques and immunosuppression available today, conventional prognostic factors have taken on less significance. Accordingly, the native renal function of the donor is thought to be more important. Thus, we analyzed the prognostic significance of the donor's renal function as assessed by 24-hour urine creatinine clearance on kidney graft survival for 10 years after living kidney transplantation.
MATERIALS AND METHODS
From January 1998 to July 2000, 71 living kidney transplantations were performed at a single institution. From among these, 68 recipients were followed for more than 6 months and were included in the present analysis. We analyzed kidney graft survival according to clinical parameters of the donor and the recipient.
RESULTS
Mean follow-up duration of recipients after living kidney transplantation was 115.0+/-39.4 months (range, 10 to 157 months), and 31 recipients (45.6%) experienced kidney graft loss during this time period. Estimated mean kidney graft survival time was 131.8+/-6.2 months, and 5-year and 10-year kidney graft survival rates were estimated as 88.2% and 61.0%, respectively. Donor's mean 24-hour urine creatinine clearance (Ccr) before kidney transplantation was 122.8+/-21.2 ml/min/1.73 m2 (range, 70.1 to 186.6 ml/min/1.73 m2). The 10-year kidney graft survival rates for cases stratified by a donor's Ccr lower and higher than 120 ml/min/1.73 m2 were 39.0% and 67.2%, respectively (p=0.005). In univariate and multivariate analysis, donor's Ccr was retained as an independent prognostic factor of kidney graft survival (p=0.001 and 0.005, respectively).
CONCLUSIONS
Donor's 24-hour urine Ccr before living kidney transplantation was an independent prognostic factor of kidney graft survival. Therefore, it should be considered before living kidney transplantation.

Keyword

Creatinine; Kidney transplantation; Survival

MeSH Terms

Creatinine
Follow-Up Studies
Graft Survival
Humans
Immunosuppression
Kidney
Kidney Transplantation
Multivariate Analysis
Tissue Donors
Transplants
Creatinine

Figure

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  FIG. 1 Kaplan-Meier curve for kidney graft survival of recipients according to donor's Ccr before kidney transplantation. Ccr, 24-hour urine creatinine clearance.

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