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

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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.

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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

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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.

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Author notes

  1. David P. Al-Adra and Maria Lambadaris contributed equally to this work.

Authors and Affiliations

  1. Kidney Transplant Program, Toronto General Hospital, University Health Network, Toronto, Canada

    David P. Al-Adra, Maria Lambadaris, Andrew Barbas, Yanhong Li, Markus Selzner, Sunita K. Singh, Olusegun Famure, S. Joseph Kim & Anand Ghanekar

  2. Division of General Surgery, University Health Network, Toronto, Canada

    David P. Al-Adra, Andrew Barbas, Markus Selzner & Anand Ghanekar

  3. Department of Surgery, University of Toronto, Toronto, Canada

    David P. Al-Adra, Andrew Barbas, Markus Selzner & Anand Ghanekar

  4. Division of Nephrology, University Health Network, Toronto, Canada

    Sunita K. Singh & S. Joseph Kim

  5. Department of Medicine, University of Toronto, Toronto, Canada

    Sunita K. Singh & S. Joseph Kim

  6. Toronto General Hospital, 11 PMB 171, 585 University Avenue, Toronto, ON, M5G 2N2, Canada

    Anand Ghanekar

Authors
  1. David P. Al-Adra
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  2. Maria Lambadaris
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  3. Andrew Barbas
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  4. Yanhong Li
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  5. Markus Selzner
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  6. Sunita K. Singh
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  7. Olusegun Famure
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  8. S. Joseph Kim
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  9. Anand Ghanekar
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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.

Corresponding author

Correspondence to Anand Ghanekar.

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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.

Additional information

S. Joseph Kim and Anand Ghanekar jointly directed this work.

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Al-Adra, D.P., Lambadaris, M., Barbas, A. et al. Donor kidney volume measured by computed tomography is a strong predictor of recipient eGFR in living donor kidney transplantation. World J Urol 37, 1965–1972 (2019). https://doi.org/10.1007/s00345-018-2595-x

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  • DOI: https://doi.org/10.1007/s00345-018-2595-x

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