Korean J Transplant.  2020 Dec;34(Supple 1):S3. 10.4285/ATW2020.OP-1046.

Impact of kidney and recipient weight incompatibility on the allograft outcomes in kidney transplant recipients with pre-transplant diabetes mellitus: a single center retrospective cohort study

• Park Y
• Lee H
• Ko J
• Yang CW
• Chung BH

• KMID: 2509123
• DOI: http://doi.org/10.4285/ATW2020.OP-1046

Abstract

Background
The aim of this study was to analyze the impact on the adverse allograft outcome of transplanting relatively small kidneys in patients with pre-transplant diabetes mellitus (DM).
Methods
From January 2010 to December 2018, 1,290 kidney transplants (KTs) were performed in Seoul St. Mary’s Hospital. Of these, 793 cases of non-sensitized living donor KT recipients were enrolled. They were divided into four groups (non-DM large kidney, non-DM small kidney, DM large kidney, and DM small kidney) according to the median kidney weight and recipient weight ratio (2.9 g/kg) and presence or absence of pre-transplant DM. The primary outcome of this study was death censored graft loss (DCGL) rate.
Results
There was no significant difference in the biopsy-proven acute rejection rate among the four groups. DM small kidney group showed the highest DCGL rate (18/131 [13.7%], P=0.004) and was to be the independent risk factor for DCGL (adjusted hazard ratio, 2.829; P=0.003). Moreover, renal function after 4 years of transplantation worsened faster in the DM small kidney group compared to other groups, and allograft survival decreased after 1 year of transplantation.
Conclusions
Our results suggest that transplanting large kidneys rather than small kidneys is considered to have an advantage in terms of allograft outcome in pre-transplant DM patients, and this should be considered in donor selection.