Document Detail


Effect of donor kidney volume on recipient outcome: does the "dose" matter?
MedLine Citation:
PMID:  23060282     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The effect of donor kidney volume on recipient kidney function has not been fully evaluated.
METHODS: We performed a prospective analysis of 125 consecutive living kidney donor/recipient pairs. Donor kidney volume was calculated from pretransplantation computed tomography angiograms using a three-dimensional computerized volume method. Cortical volume was calculated from arterial phase and total volume from delayed phase. Because weight is a surrogate marker for metabolic demands, we looked at the "volume dose" by calculating the ratio of donor kidney volume to recipient weight. Recipient kidney function was assessed by calculating the estimated glomerular filtration rate (eGFR) using the Chronic Kidney Disease Epidemiology Collaboration formula. Logistic regression models were used to evaluate odds of developing eGFR of <60 mL/min per 1.73m(2) (eGFR<60) at 12 months.
RESULTS: Because cortical and total volumes were correlated (R=0.734, P<0.001), we used total kidney volume to evaluate the dose effect. The mean donated volume dose (SD) was 2.13 (0.62) mL/kg. The mean recipient eGFR at 12 months was 63.6 (17.3) mL/min per 1.73 m, and it correlated with volume dose (r=0.341, P<0.001). Compared with the lowest tertile, those in the highest tertile of donor kidney volume to recipient weight had lower odds ratio of developing eGFR of less than 60 mL/min per 1.73 m(2) (odds ratio, 0.23; 95% confidence interval, 0.07-0.81) in a multivariate logistic regression model. Spline regression suggested that a volume dose greater than 2.5 mL/kg was associated with lowest risk of eGFR of less than 60 mL/min per 1.73 m(2) at 12 months.
CONCLUSIONS: Donor kidney volume dosing is an important determinant of recipient graft outcomes and may predict recipient kidney function in kidney transplantation.
Authors:
Magdalena B Sikora; Akram Shaaban; Srinivasan Beddhu; Hassan Bourija; Guo Wei; Bradley Baird; Crystal M Truax; Fuad S Shihab
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation     Volume:  94     ISSN:  1534-6080     ISO Abbreviation:  Transplantation     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-12     Completed Date:  2013-02-07     Revised Date:  2013-05-10    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1124-30     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Transplant Program, University of Utah, 30 N. 1900 E., Salt Lake City, UT 84132, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Glomerular Filtration Rate
Humans
Imaging, Three-Dimensional
Kidney / physiopathology,  radiography*,  surgery*
Kidney Transplantation* / adverse effects
Living Donors*
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Organ Size
Predictive Value of Tests
Prospective Studies
Radiographic Image Interpretation, Computer-Assisted
Risk Assessment
Risk Factors
Time Factors
Tomography, X-Ray Computed*
Treatment Outcome
Young Adult
Comments/Corrections
Comment In:
Transplantation. 2013 Apr 15;95(7):e46   [PMID:  23545514 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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