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Choosing the larger kidney on CT volumetry: a study on the early post-donation kidney function of living donors

  • Urology - Original Paper
  • Published:
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Abstract

Background

Selecting the smaller kidney for donation has been advocated if there is a size difference of > 10% between the 2 kidneys but has never been prospectively evaluated. With increase in donor nephrectomies, it is important to evaluate this to minimize loss of renal function to donors.

Methods

75 consecutive donor nephrectomy patients were included in our longitudinal study. The Split Renal Volume (SRV) of bilateral kidneys were measured using contrasted computer tomography scans and patients segregated into 2 groups depending on donated kidney having more (Group 1) or less than (Group 2) 52.5% of SRV.

Results

Patients in Group 1 (n = 19) and 2 (n = 56) were of similar age (43.8 vs. 48.3), BMI (22.4 vs. 25.2), sex (57.9 vs. 55.4% women), respectively. Although total kidney volumes were similar in both groups, Group 1 had significantly smaller right kidney volumes (120.4 ± 24.9 vs. 142.7 ± 28.4 mls, p = 0.003). EGFR pre-operatively (116.3 ± 20.8 vs. 106.3 ± 23.8 mL/min/1.73 m2) and at 6-months (65.7 ± 13.3 vs. 66.9 ± 15.5 mL/min/1.73 m2) were not different between groups. However, patients in Group 1 had significantly greater absolute (50.6 ± 14.9 vs. 39.5 ± 14.7 mL/min/1.73 m2) and relative decline (43.0 ± 8.6 vs. 36.3 ± 10.6%) in eGFR at 6 months (p = 0.06, 0.009).

Conclusion

With a SRV difference of 5% between the 2 sides, removal of the larger kidney for living kidney donation resulted in greater early decline of renal function than kidney donors whose larger or equivalent kidney is preserved.

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Data availability

Data of this study is available upon request from the corresponding author.

Abbreviations

ESKD:

End stage kidney disease

LKD:

Living kidney donor

SRV:

Split renal volume

SRF:

Split renal function

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Funding

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Authors and Affiliations

  1. Department of Urology, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore

    Lin Kyaw, Lynnette Tan, Benjamin Goh, Jirong Lu, Lata Raman & Ho Yee Tiong

  2. Divison of Urology, Ng Teng Fong General Hospital, Singapore, Singapore

    Karthik Thandapani

  3. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Hong Min Peng, Benjamin Goh, Vathsala Anantharaman & Ho Yee Tiong

  4. National University Centre for Organ Transplantation, Singapore, Singapore

    Benjamin Goh, Jirong Lu, Vathsala Anantharaman & Ho Yee Tiong

  5. School of Public Health, National University Singapore, Singapore, Singapore

    Bee Choo Tai

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  1. Lin Kyaw
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Contributions

LK: Project development, data analysis, manuscript writing. KT: Project development, data analysis, manuscript writing. LT: Data collection, data analysis, manuscript writing. HMP: Data collection, data analysis. BG: Project development. JL: Project development, Data analysis. LR: Data collection, Data analysis. CTB: Data analysis. VA: Manuscript writing. HYT: Project development, data analysis, manuscript writing.

Corresponding author

Correspondence to Ho Yee Tiong.

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2013/00497-SRF0002.

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Kyaw, L., Thandapani, K., Tan, L. et al. Choosing the larger kidney on CT volumetry: a study on the early post-donation kidney function of living donors. Int Urol Nephrol 56, 97–102 (2024). https://doi.org/10.1007/s11255-023-03737-4

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  • DOI: https://doi.org/10.1007/s11255-023-03737-4

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