Donor kidney glomerular filtration rate and donor/recipient body surface area ratio influence graft function in living related kidney transplantation

Liu, Jinfeng; Liu, Jia; Guo, Tao; Shang, Wenjun; Pang, Xinlu; Feng, Yue; Gao, Feng

doi:10.3109/0886022x.2015.1007805

Cited by 8 publications

(6 citation statements)

References 15 publications

(14 reference statements)

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“…GFR rate was estimated using the novel Chronic Kidney Disease-Epidemiology Collaboration equation based on sCr [13,14] . All the donors and recipients' BSAs were estimated by the formula of Mosteller [15,16] Variables related with the presence of simple renal cysts by means of above analysis (p < 0.2) were included in the multivariate logistic regression model in forward stepwise fashion, to confirm independent predictive factors of renal cyst formation. Variance inflation factors (VIF) were calculated to check for collinearity; VIF value >10 meant serious collinearity between the variables.…”

Section: Auxiliary Examination Information and Statistical Analysismentioning

confidence: 99%

Simple Cysts in Donor Kidney Contribute to Reduced Allograft Function

Qiu

Jiang²,

Wu³

et al. 2016

Am J Nephrol

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Background: Simple renal cysts may be an early marker of renal disease. We investigated whether simple cysts in donor kidney are associated with the decline of allograft function in living donor kidney transplantation. Methods: We retrospectively reviewed records of donors and recipients from 716 living donor kidney transplants performed between April 2007 and April 2015 in our hospital. Ninety-one donors with renal cysts and 64 recipients with cysts in donor kidney were noted. We compared these 64 cases to 128 no cyst-bearing controls matched for the donor gender, recipient gender, donor baseline serum creatinine (sCr), donor/recipient body surface area ratio, donor age, recipient age and the date of kidney transplantation in turn. Results: The presence of cysts was interrelated with age, gender and renal function independently in donors. Pathological findings of time-zero biopsy revealed that donor kidney harboring cysts existed more glomerular sclerosis compared with no cyst-bearing controls (p = 0.040). The estimating glomerular filtration rate levels of recipients were 80.82 ± 26.61 vs. 88.21 ± 23.12, 66.95 ± 17.42 vs. 72.15 ± 16.42 and 60.92 ± 22.17 vs. 68.72 ± 14.43 ml/min· 1.73 m² in cyst-bearing and no cyst-bearing group on day 7, month 6 and year 5, respectively, after surgery (p < 0.05). The mean sCr were 112.14 ± 48.32 vs. 98.75 ± 29.71 and 126.28 ± 42.32 vs. 115.05 ± 26.35 μmol/l on the 7th day and a half year after transplant, respectively (p < 0.05). The 2 groups did not significantly differ in terms of the other characteristics. Conclusion: Simple cysts in donor kidney can influence the early and long-term allograft function. In living donor transplantation, kidney presenting cysts should be considered carefully at the time of donor selection.

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Section: Auxiliary Examination Information and Statistical Analysismentioning

confidence: 99%

Simple Cysts in Donor Kidney Contribute to Reduced Allograft Function

Qiu

Jiang²,

Wu³

et al. 2016

Am J Nephrol

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“…When HLA mismatch number were different among multiple donors, we selected the donor with the smallest number of HLA mismatch (n = 10). Donor /recipient BSA ratio is a reliable indicator of nephron dosing 13 . Donor/recipient BSA ratio > 1.3 was a contraindication to kidney transplantation in our center.…”

Section: Resultsmentioning

confidence: 99%

Barriers to the donation of living kidneys for kidney transplantation

Min

Koo²,

Hwang

et al. 2022

Sci Rep

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Since the waiting time for deceased donor kidney transplantation continues to increase, living donor kidney transplantation is an important treatment for end stage kidney disease patients. Barriers to living kidney donation have been rarely investigated despite a growing interest in the utilization of living donor transplantation and the satisfaction of donor safety. Here, we retrospectively analyzed 1658 potential donors and 1273 potential recipients who visited the Seoul National University Hospital for living kidney transplantation between 2010 and 2017 to study the causes of donation discontinuation. Among 1658 potential donors, 902 (54.4%) failed to donate kidneys. The average number of potential donors that received work-up was 1.30 ± 0.66 per recipient. Among living donor kidney transplant patients, 75.1% received kidneys after work-up of the first donor and 24.9% needed work-up of two or more donors. Donor-related factors (49.2%) were the most common causes of donation discontinuation, followed by immunologic or size mismatches between donors and recipients (25.4%) and recipient-related factors (16.2%). Interestingly, withdrawal of donation consent along with refusal by recipients or family were the commonest causes, suggesting the importance of non-biomedical aspects. The elucidation of the barriers to living kidney donation could ensure more efficient and safer living kidney donation.

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“…The underlining challenge in such patients with extreme stature is to ensure that the physiological capacity and the functioning nephron mass of the donor organ can meet the increased metabolic needs of this unique recipients so to alleviate their need for renal replacement therapy and have a significant positive impact on their overall health, quality of life, and life expectancy. Recent studies have confirmed that the graft kidney volume/recipient BSA ratio along with the donor age and recipient’s gender are independent predictors of recipient GFR in the early post-transplant period[ 4 - 6 ]. Considering the above concern, the option of synchronous dual deceased kidney transplantation in such extreme stature patients seems reasonable and needs to be considered at the time of wait listing them for a deceased donor kidney transplant and weighted against depriving the second graft from another potential recipient given the current scarcity of deceased donor organs.…”

Section: Discussionmentioning

confidence: 99%

Renal transplantation in gigantism: A case report

Gopal¹,

Charalampidis²,

Xiang³

et al. 2022

WJT

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BACKGROUND Gigantism, characterized by excessive growth and height is due to increased secretion of growth hormone, most commonly from a pituitary adenoma. In addition to the surgical and anesthetic complexity, the extreme stature of these patients presents a unique challenge for kidney transplantation in deciding whether to proceed with a single or dual kidney transplantation. The lack of relevant literature further adds to the dilemma. CASE SUMMARY A 45-year-old patient with untreated gigantism and end stage renal failure on renal replacement therapy was waitlisted for a deceased donor dual kidney transplantation due to the extreme physical stature (Height-247 cm and weight-200 kg). He was offered 2 kidneys from a 1-0-1 HLA mismatched 24-year-old DCD donor (Height-179 cm and weight-75 kg), and was planned for a bilateral retroperitoneal implantation into the recipient external iliac vessels. The immunosuppression consisted of alemtuzumab induction (50 mg) and steroid-free maintenance with tacrolimus. The donor’s right kidney was uneventfully implanted extra-peritoneally into the right external iliac vessels. On contralateral exposure, the left common and external iliac arteries were ectatic and frail. A complex vascular reconstruction was not preferred in order to preserve the arterial supply to the left lower limb, to minimise the cold ischemia time and prevent additional warm ischemic insult to the second kidney. Hence, it was decided not to proceed with dual transplantation. Amidst concerns of nephron mass insufficiency, the graft function was remarkable with a serum creatinine of 120 µmol/L within a month from transplantation and 94 µmol/L at 1-year post transplantation, and without proteinuria. CONCLUSION To our knowledge, this is the first case report on kidney transplantation in gigantism. Although it is believed that dual kidney transplantation is ideal, a single kidney transplantation from an appropriately selected donor can provide sufficient functioning nephron mass in patients with gigantism.

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Donor kidney glomerular filtration rate and donor/recipient body surface area ratio influence graft function in living related kidney transplantation

Abstract: Both SKGFR and D/R BSA ratio should be considered for choosing potential living related donors. Donors with SKGFR < 40 mL/min and D/R BSA ratio ≤ 0.8 should be carefully selected. Satisfactory graft function in donors with SKGFR < 40 ml could be achieved if their D/R BSA ratio is >0.8.

Cited by 8 publications

References 15 publications

Simple Cysts in Donor Kidney Contribute to Reduced Allograft Function

Simple Cysts in Donor Kidney Contribute to Reduced Allograft Function

Barriers to the donation of living kidneys for kidney transplantation

Renal transplantation in gigantism: A case report

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