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Donor kidney volume measured by computed tomography is a strong predictor of recipient eGFR in living donor kidney transplantation

  • David P. Al-Adra
  • Maria Lambadaris
  • Andrew Barbas
  • Yanhong Li
  • Markus Selzner
  • Sunita K. Singh
  • Olusegun Famure
  • S. Joseph Kim
  • Anand Ghanekar
Original Article
  • 18 Downloads

Abstract

Purpose

The effect of living donor kidney allograft size on recipient outcomes is not well understood. In this study, we sought to investigate the relationship between preoperatively measured donor kidney volume and recipient estimated glomerular filtration rate (eGFR) in living donor kidney transplantation (LDKT).

Methods

We studied computed tomography (CT) donor kidney volumes and recipient outcomes for 438 LDKTs at the Toronto General Hospital between 2007 and 2016. Estimated glomerular filtration rate (eGFR) was calculated at 1, 3, and 6 months and a multivariable linear regression model was fitted to study the effect of donor kidney volume on recipient eGFR.

Results

The mean volume and weight of the donated kidneys were 157.3 (± 32.3) cc and 186.7 (± 48.7) g, respectively. Kidney volume was significantly associated with eGFR on multivariable analysis (P < 0.001). Specifically, for every 10 cc increase in kidney volume, there was a 1.68 mL/min, 1.25 mL/min and 0.97 mL/min rise in recipient eGFR at 1, 3, and 6 months, respectively.

Conclusions

Donor kidney volume is a strong independent predictor of recipient eGFR in LDKT, and therefore, may be a valuable addition to predictive models of eGFR after transplant. Further research may determine if the inclusion of donor kidney volume in matching algorithms can improve recipient outcomes.

Keywords

Living donor kidney Kidney volume Computed tomography eGFR prediction Outcomes 

Abbreviations

BMI

Body mass index

CKD-EPI

Chronic kidney disease epidemiology collaboration formula

CNI

Calcineurin inhibitor

CT

Computed tomography

eGFR

Estimated glomerular filtration rate

LDKT

Living donor kidney transplantation

MSE

Mean squared error

PRA

Pannel reactive antibody

Notes

Acknowledgements

The authors thank the students of the multi-organ transplant student research training program for their dedication and diligence in collecting, entering, and auditing data for CoReTRIS at the Toronto General Hospital, University Health Network.

Authors’ contributions

Al-Adra: Project development, Data collection and Management, Data analysis, Manuscript writing and editing. Lambadaris: Project development, Data collection and Management, Data analysis, Manuscript writing and editing. Barbas: Data collection and Management. Li: Data analysis. Selzner: Manuscript writing and editing. Singh: Manuscript writing and editing. Famure: Project development, Data analysis. Kim: Project development, Data analysis, Manuscript writing and editing. Ghanekar: Project development, Data analysis, Manuscript writing and editing.

Compliance with ethical standards

Conflict of interest

The authors of this manuscript have no conflicts of interest to disclose. Research was approved by University Health Network Institutional Review Board.

Supplementary material

345_2018_2595_MOESM1_ESM.docx (19 kb)
Supplementary material 1 (DOCX 19 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • David P. Al-Adra
    • 1
    • 2
    • 3
  • Maria Lambadaris
    • 1
  • Andrew Barbas
    • 1
    • 2
    • 3
  • Yanhong Li
    • 1
  • Markus Selzner
    • 1
    • 2
    • 3
  • Sunita K. Singh
    • 1
    • 4
    • 5
  • Olusegun Famure
    • 1
  • S. Joseph Kim
    • 1
    • 4
    • 5
  • Anand Ghanekar
    • 1
    • 2
    • 3
    • 6
  1. 1.Kidney Transplant ProgramToronto General Hospital, University Health NetworkTorontoCanada
  2. 2.Division of General SurgeryUniversity Health NetworkTorontoCanada
  3. 3.Department of SurgeryUniversity of TorontoTorontoCanada
  4. 4.Division of NephrologyUniversity Health NetworkTorontoCanada
  5. 5.Department of MedicineUniversity of TorontoTorontoCanada
  6. 6.Toronto General HospitalTorontoCanada

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